Layer arrangements for surgical staple cartridges

ABSTRACT

A staple cartridge assembly includes, one, a plurality of staples movable between unfired positions and fired positions and, two, a layer, such as a tissue thickness compensator and/or a buttress material, for example, wherein the staples are configured to at least partially capture the layer when the staples are moved between the unfired positions and the fired positions. The layer can include a cushioning member at least partially extending around a peripheral portion of the tissue thickness compensator. The layer can include features which create a flexible transition between the tissue supported by the layer and the staples and the unsupported tissue.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation application claiming priority under35 U.S.C. §120 to U.S. patent application Ser. No. 13/763,095, entitledLAYER ARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES, filed Feb. 8, 2013,now U.S. Patent Application Publication No. 2013/0161374, which is acontinuation-in-part application claiming priority under 35 U.S.C. §120to U.S. patent application Ser. No. 12/032,002, entitled SURGICAL ENDEFFECTOR HAVING BUTTRESS RETENTION FEATURES, filed Feb. 15, 2008, whichissued on Feb. 12, 2013 as U.S. Pat. No. 8,371,491, the entiredisclosures of which are hereby incorporated by reference herein.

BACKGROUND

The present invention relates to surgical instruments and, in variousembodiments, to surgical cutting and stapling instruments and staplecartridges therefor that are designed to cut and staple tissue.

BRIEF DESCRIPTION OF THE DRAWINGS

The features and advantages of this invention, and the manner ofattaining them, will become more apparent and the invention itself willbe better understood by reference to the following description ofexemplary embodiments of the invention taken in conjunction with theaccompanying drawings, wherein:

FIG. 1 is a perspective view of an end effector assembly attached to adistal end of a surgical instrument in accordance with one non-limitingembodiment of the present invention;

FIG. 2 is a perspective view of an end effector assembly including atleast one piece of buttress material, wherein the end effector assemblyis in an open configuration in accordance with one non-limitingembodiment of the present invention;

FIG. 3 is a perspective view of a staple cartridge of the end effectorassembly of FIG. 2, wherein the buttress material is releasably retainedthereto;

FIG. 4 is a partial perspective view of an end effector assembly withsome components removed, wherein the end effector assembly includes aretractable member configured to releasably retain at least one piece ofbuttress material;

FIG. 5 is a perspective view of an anvil of the end effector assembly ofFIG. 2, wherein the anvil has at least one piece of buttress materialreleasably retained thereto;

FIG. 6 is an exploded view of an end effector assembly including astaple cartridge and an anvil in accordance with one non-limitingembodiment of the present invention;

FIG. 7 is an exploded view of the end effector assembly of FIG. 6 withsome components removed;

FIG. 8 is an exploded perspective view of a staple cartridge and a pieceof buttress material, wherein the piece of buttress material includes aplurality of members extending therefrom;

FIG. 9 is a cross-sectional view of a piece of buttress materialincluding members engaged with staple cavities of a staple cartridge inaccordance with one non-limiting embodiment of the present invention;

FIG. 10 is an exploded view of FIG. 9 illustrating the members separatedfrom the staple cavities of the staple cartridge in accordance with onenon-limiting embodiment of the present invention;

FIG. 11 is an exploded perspective view of a handle assembly of asurgical stapling instrument;

FIG. 12 is a side cross-sectional view of the surgical staplinginstrument shown in FIG. 11 illustrating the handle assembly in anon-actuated position;

FIG. 13 is an exploded perspective view of a portion of the surgicalstapling instrument shown in FIG. 11;

FIG. 14 is an enlarged view of the indicated area of detail shown inFIG. 12;

FIG. 15 is a perspective view of a non-articulating disposable loadingunit usable with the surgical stapling instrument shown in FIG. 11;

FIG. 16 is a perspective view of an articulating disposable loading unitusable with the surgical stapling instrument shown in FIG. 11;

FIG. 17 is a perspective view of a disposable loading unit usable withthe surgical stapling instrument of FIG. 11;

FIG. 18 is another perspective view of a disposable loading unit usablewith the surgical stapling instrument of FIG. 11;

FIG. 19 is an exploded perspective view of an end effector for use withthe surgical stapling instrument of FIG. 11;

FIG. 20 is an enlarged perspective view of the distal end of a staplecartridge for use with the surgical stapling instrument shown in FIG.11;

FIG. 21 is a side cross-sectional view taken along the section lineindicated in FIG. 20;

FIG. 22 is a bottom perspective view of the staple cartridge shown inFIG. 20;

FIG. 23 is an enlarged perspective view of the actuation sled, thepushers and the fasteners shown in FIG. 21;

FIG. 24 is an enlarged perspective view of the mounting assembly of thedisposable loading unit shown in FIG. 17 mounted to a distal end portionof the proximal housing portion;

FIG. 25 is an enlarged perspective view of the proximal housing portionand the mounting assembly of the disposable loading unit shown in FIG.17 with the upper housing half removed;

FIG. 26 is a perspective view of the proximal housing portion and themounting assembly of the disposable loading unit shown in FIG. 17 withthe upper housing half removed;

FIG. 27 is a perspective view with parts separated of an axial driveassembly;

FIG. 28 is a perspective view of the surgical stapling apparatus shownin FIG. 11 with the disposable loading unit of FIG. 17 detachedtherefrom;

FIG. 29 is another perspective view of the surgical stapling instrumentof FIG. 1;

FIG. 30 is an exploded view of an end effector assembly for use with thesurgical stapling instrument of FIG. 29;

FIG. 31 is a perspective view of a staple cartridge portion of the endeffector assembly of FIG. 30;

FIG. 32 is a partial perspective view of an end effector for use withthe surgical stapling instrument of FIG. 29;

FIG. 33 is a partial detail view of the end effector of FIG. 32;

FIG. 33A is an exploded perspective view of an end effector of astapling instrument comprising a staple cartridge and a tissue thicknesscompensator according to various embodiments;

FIG. 34 is a perspective view of tissue thickness compensators fastenedto tissue according to various embodiments;

FIG. 35 is a partial cross sectional view of a tissue thicknesscompensator including a plurality of openings and a plurality ofcavities according to various embodiments;

FIG. 36 is a perspective view of a tissue thickness compensatorincluding pyramid-shaped cleats according to various embodiments;

FIG. 37 is a cross sectional view of the tissue thickness compensator inFIG. 36;

FIG. 38 is a perspective view of a corrugated tissue thicknesscompensator according to various embodiments;

FIG. 39 is a cross sectional view of the tissue thickness compensator inFIG. 38;

FIG. 40 is a perspective view of a tissue thickness compensatorincluding a scalloped outer edge according to various embodiments;

FIG. 41 is a perspective view of a tissue thickness compensatorincluding a scalloped outer edge according to various embodiments;

FIG. 42 is a perspective view of a tissue thickness compensatorincluding a cushioning member according to various embodiments;

FIG. 43 is a cross sectional view of the tissue thickness compensator inFIG. 42;

FIG. 44 is a cross sectional view of the tissue thickness compensator ofFIG. 42 fastened to tissue according to various embodiments;

FIG. 45 is a perspective view of a tissue thickness compensatorincluding a rolled outer edge according to various embodiments;

FIG. 46 is a partial cross sectional view of the rolled outer edge inFIG. 45;

FIG. 47 is an exploded perspective view of an end effector of a staplinginstrument comprising a staple cartridge and a tissue thicknesscompensator according to various embodiments;

FIG. 48 is a cross sectional view of the tissue thickness compensator inFIG. 47 according to various embodiments;

FIG. 49 is a top view of a tissue thickness compensator including aplurality of circular pieces according to various embodiments;

FIG. 50 is a top view of a tissue thickness compensator including aplurality of circular pieces according to various embodiments;

FIG. 51 is a cross sectional view of a tissue thickness compensatoraccording to various embodiments;

FIG. 52 is a top view of a tissue thickness compensator according tovarious embodiments;

FIG. 53 is a top view of a tissue thickness compensator including aplurality of hexagonal pieces according to various embodiments;

FIG. 54 is a top view of a fastened tissue thickness compensatorincluding a plurality of pieces according to various embodiments;

FIG. 55 is a top view of a tissue thickness compensator including aplurality of slits according to various embodiments;

FIG. 55A is an exploded perspective view of an end effector of astapling instrument comprising a staple cartridge and a tissue thicknesscompensator according to various embodiments;

FIG. 55B is a cross sectional view of tissue thickness compensatorsfastened to tissue according to various embodiments;

FIG. 56 is a perspective view of a tissue thickness compensatoraccording to various embodiments;

FIG. 57 is a detail view of the tissue thickness compensator in FIG. 56;

FIG. 58 is a plan view of two layers at least partially overlapping witheach other;

FIG. 59 is a perspective view of a staple cartridge utilizing one of thelayers illustrated in FIG. 58;

FIG. 60 is a perspective view of a layer configured to be used inconnection with a staple cartridge;

FIG. 60A is a perspective view of the layer of FIG. 60 attached to astaple cartridge;

FIG. 60B is a detail view of adjacent layers at least partiallyoverlapping with each other;

FIG. 61 is an exploded view of a staple cartridge assembly including acartridge body and a layer assembly which includes a first layer and asecond layer;

FIG. 62 is a side view of tissue T captured between layer assemblies byfired staples from the staple cartridge assembly of FIG. 61;

FIG. 63 is a cross-sectional view of the layer assembly of FIG. 61showing the first layer and the second layer;

FIG. 64 is a perspective view of a fastener cartridge assembly for usewith an end effector assembly according to various embodiments of thepresent disclosure, depicting a layer of material released from acartridge body of the fastener cartridge assembly;

FIG. 65 is an elevation view of the fastener cartridge assembly of FIG.64 with various elements removed therefrom, depicting the layer ofmaterial secured to the cartridge body by a proximal connector and by adistal connector, and further depicting a firing assembly in an unfiredposition;

FIG. 66 is an elevation view of the fastener cartridge assembly of FIG.64 with various elements removed therefrom, depicting the layer ofmaterial secured to the cartridge body by the distal connector, andfurther depicting the firing assembly in a partially fired position;

FIG. 67 is a perspective view of a fastener cartridge assembly for usewith an end effector assembly according to various embodiments of thepresent disclosure, depicting a layer of material released from acartridge body of the fastener cartridge assembly;

FIG. 68 is a perspective view of the fastener cartridge assembly of FIG.67, depicting the layer of material secured to the cartridge body by aproximal connector and by a distal connector;

FIG. 69 is a cross-sectional, perspective view of the fastener cartridgeassembly of FIG. 67 taken along the plane indicated in FIG. 68,depicting the layer of material secured to the cartridge body by theproximal connector;

FIG. 70 is a cross-sectional, elevation view of the layer of material ofFIG. 67 taken along the plane indicated in FIG. 68;

FIG. 71 is a cross-sectional, elevation view of a layer of material foruse with an end effector assembly according to various embodiments ofthe present disclosure;

FIG. 72 is a perspective view of a fastener cartridge assembly for usewith an end effector assembly according to various embodiments of thepresent disclosure, depicting a layer of material released from acartridge body of the fastener cartridge assembly;

FIG. 73 is a perspective view of the fastener cartridge assembly of FIG.72, depicting the layer of material secured to the cartridge body by afirst connector and by a second connector;

FIG. 74 is a cross-sectional, perspective view of the fastener cartridgeassembly of FIG. 72 taken along the plane indicated in FIG. 73,depicting the layer of material secured to the cartridge body by theproximal connector of FIG. 73;

FIG. 75 is a cross-sectional, elevation view of the layer of material ofFIG. 72 taken along the plane indicated in FIG. 73;

FIG. 76 is a perspective view of a fastener cartridge assembly for usewith an end effector assembly according to various embodiments of thepresent disclosure, depicting a layer of material released from acartridge body of the fastener cartridge assembly;

FIG. 77 is a perspective view of the fastener cartridge assembly of FIG.76, depicting the layer of material secured to the cartridge body by aproximal connector and by a distal connector;

FIG. 78 is a perspective view of a fastener cartridge assembly for usewith an end effector assembly according to various embodiments of thepresent disclosure, depicting a layer of material released from acartridge body of the fastener cartridge assembly;

FIG. 79 is a cross-sectional, elevation view of the fastener cartridgeassembly of FIG. 78, depicting the layer of material secured to thecartridge body;

FIG. 80 is a cross-sectional, perspective view of the fastener cartridgeassembly of FIG. 78, depicting the layer of material secured to thecartridge body;

FIG. 80A is a perspective view of a layer of material for use with anend effector assembly according to various embodiments of the presentdisclosure;

FIG. 80B is a perspective view of the layer of material of FIG. 80A;

FIG. 81 is a partial, perspective view of a jaw of an end effectorassembly according to various embodiments of the present disclosure,depicting a layer of material secured to a cartridge body by a distalconnector, and further depicting an actuator in a pre-actuated position;

FIG. 82 is a partial, perspective view of the jaw of FIG. 81, depictinga firing assembly against a release stop of the actuator, depicting theactuator in an actuated position, and further depicting the distalconnector broken by the actuator;

FIG. 83 is a partial, perspective view of the jaw of FIG. 81, depictingthe release stop of the actuator broken by the firing assembly, andfurther depicting the foot of the firing assembly distal to the releasestop;

FIG. 84 is a detail, perspective view of the release stop of FIG. 83broken by the firing assembly;

FIG. 85 is a perspective view of a jaw of an end effector assemblyaccording to various embodiments of the present disclosure, the jawhaving various elements removed therefrom, depicting an actuator in apre-actuated position, and further depicting a distal connector;

FIG. 86 is a partial, perspective view of the jaw of FIG. 85, depictingthe actuator in an actuated position, and further depicting the distalconnector broken by the actuator;

FIG. 87 is an exploded view of a staple cartridge and a tissue thicknesscompensator in accordance with at least one embodiment;

FIG. 88A is a cross-sectional view of the staple cartridge and thetissue thickness compensator of FIG. 87 showing unformed staplessupported by staple drivers;

FIG. 88B is a cross-sectional view of the tissue thickness compensatorof FIG. 87 captured by formed staples;

FIG. 88 is a cross-sectional view of a tissue thickness compensator inaccordance with at least one embodiment;

FIG. 89 is a cross-sectional view of a tissue thickness compensator inaccordance with at least one embodiment; and

FIG. 90 is a cross-sectional view of a tissue thickness compensator inaccordance with at least one embodiment.

DETAILED DESCRIPTION

The Applicant of the present application also owns the U.S. patentapplications identified below which are each herein incorporated byreference in their respective entirety:

U.S. patent application Ser. No. 12/894,311, entitled SURGICALINSTRUMENTS WITH RECONFIGURABLE SHAFT SEGMENTS, now U.S. Pat. No.8,763,877;

U.S. patent application Ser. No. 12/894,340, entitled SURGICAL STAPLECARTRIDGES SUPPORTING NON-LINEARLY ARRANGED STAPLES AND SURGICALSTAPLING INSTRUMENTS WITH COMMON STAPLE-FORMING POCKETS, now U.S. Pat.No. 8,899,463;

U.S. patent application Ser. No. 12/894,327, entitled JAW CLOSUREARRANGEMENTS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 8,978,956;

U.S. patent application Ser. No. 12/894,351, entitled SURGICAL CUTTINGAND FASTENING INSTRUMENTS WITH SEPARATE AND DISTINCT FASTENER DEPLOYMENTAND TISSUE CUTTING SYSTEMS, now U.S. Pat. No. 9,113,864;

U.S. patent application Ser. No. 12/894,338, entitled IMPLANTABLEFASTENER CARTRIDGE HAVING A NON-UNIFORM ARRANGEMENT, now U.S. Patent No.8,864,007;

U.S. patent application Ser. No. 12/894,369, entitled IMPLANTABLEFASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER, now U.S. PatentApplication Publication No. 2012/0080344;

U.S. patent application Ser. No. 12/894,312, entitled IMPLANTABLEFASTENER CARTRIDGE COMPRISING MULTIPLE LAYERS, now U.S. Pat. No.8,925,782;

U.S. patent application Ser. No. 12/894,377, entitled SELECTIVELYORIENTABLE IMPLANTABLE FASTENER CARTRIDGE, now U.S. Pat. No. 8,393,514;

U.S. patent application Ser. No. 12/894,339, entitled SURGICAL STAPLINGINSTRUMENT WITH COMPACT ARTICULATION CONTROL ARRANGEMENT, now U.S. Pat.No. 8,840,003;

U.S. patent application Ser. No. 12/894,360, entitled SURGICAL STAPLINGINSTRUMENT WITH A VARIABLE STAPLE FORMING SYSTEM, now U.S. Pat. No.9,113,862;

U.S. patent application Ser. No. 12/894,322, entitled SURGICAL STAPLINGINSTRUMENT WITH INTERCHANGEABLE STAPLE CARTRIDGE ARRANGEMENTS, now U.S.Pat. No. 8,740,034;

U.S. patent application Ser. No. 12/894,350, entitled SURGICAL STAPLECARTRIDGES WITH DETACHABLE SUPPORT STRUCTURES AND SURGICAL STAPLINGINSTRUMENTS WITH SYSTEMS FOR PREVENTING ACTUATION MOTIONS WHEN ACARTRIDGE IS NOT PRESENT, now U.S. Patent Application Publication No.2012/0080478;

U.S. patent application Ser. No. 12/894,383, entitled IMPLANTABLEFASTENER CARTRIDGE COMPRISING BIOABSORBABLE LAYERS, now U.S. Patent No.8,752,699;

U.S. patent application Ser. No. 12/894,389, entitled COMPRESSIBLEFASTENER CARTRIDGE, now U.S. Pat. No. 8,740,037;

U.S. patent application Ser. No. 12/894,345, entitled FASTENERSSUPPORTED BY A FASTENER CARTRIDGE SUPPORT, now U.S. Pat. No. 8,783,542;

U.S. patent application Ser. No. 12/894,306, entitled COLLAPSIBLEFASTENER CARTRIDGE, now U.S. Pat. No. 9,044,227;

U.S. patent application Ser. No. 12/894,318, entitled FASTENER SYSTEMCOMPRISING A PLURALITY OF CONNECTED RETENTION MATRIX ELEMENTS, now U.S.Pat. No. 8,814,024;

U.S. patent application Ser. No. 12/894,330, entitled FASTENER SYSTEMCOMPRISING A RETENTION MATRIX AND AN ALIGNMENT MATRIX, now U.S. Pat. No.8,757,465;

U.S. patent application Ser. No. 12/894,361, entitled FASTENER SYSTEMCOMPRISING A RETENTION MATRIX, now U.S. Pat. No. 8,529,600;

U.S. patent application Ser. No. 12/894,367, entitled FASTENINGINSTRUMENT FOR DEPLOYING A FASTENER SYSTEM COMPRISING A RETENTIONMATRIX, now U.S. Pat. No. 9,033,203;

U.S. patent application Ser. No. 12/894,388, entitled FASTENER SYSTEMCOMPRISING A RETENTION MATRIX AND A COVER, now U.S. Pat. No. 8,474,677;

U.S. patent application Ser. No. 12/894,376, entitled FASTENER SYSTEMCOMPRISING A PLURALITY OF FASTENER CARTRIDGES, now U.S. Pat. No.9,044,228;

U.S. patent application Ser. No. 13/097,865, entitled SURGICAL STAPLERANVIL COMPRISING A PLURALITY OF FORMING POCKETS, now U.S. Pat. No.9,295,464;

U.S. patent application Ser. No. 13/097,936, entitled TISSUE THICKNESSCOMPENSATOR FOR A SURGICAL STAPLER, now U.S. Pat. No. 8,657,176;

U.S. patent application Ser. No. 13/097,954, entitled STAPLE CARTRIDGECOMPRISING A VARIABLE THICKNESS COMPRESSIBLE PORTION, now U.S. PatentApplication Publication No. 2012/0080340;

U.S. patent application Ser. No. 13/097,856, entitled STAPLE CARTRIDGECOMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF, nowU.S. Patent Application Publication No. 2012/0080336;

U.S. patent application Ser. No. 13/097,928, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING DETACHABLE PORTIONS, now U.S. Pat. No. 8,746,535;

U.S. patent application Ser. No. 13/097,891, entitled TISSUE THICKNESSCOMPENSATOR FOR A SURGICAL STAPLER COMPRISING AN ADJUSTABLE ANVIL, nowU.S. Pat. No. 8,864,009;

U.S. patent application Ser. No. 13/097,948, entitled STAPLE CARTRIDGECOMPRISING AN ADJUSTABLE DISTAL PORTION, now U.S. Pat. No. 8,978,954;

U.S. patent application Ser. No. 13/097,907, entitled COMPRESSIBLESTAPLE CARTRIDGE ASSEMBLY, now U.S. Pat. No. 9,301,755;

U.S. patent application Ser. No. 13/097,861, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING PORTIONS HAVING DIFFERENT PROPERTIES, now U.S.Pat. No. 9,113,865;

U.S. patent application Ser. No. 13/097,869, entitled STAPLE CARTRIDGELOADING ASSEMBLY, now U.S. Pat. No. 8,857,694;

U.S. patent application Ser. No. 13/097,917, entitled COMPRESSIBLESTAPLE CARTRIDGE COMPRISING ALIGNMENT MEMBERS, now U.S. Pat. No.8,777,004;

U.S. patent application Ser. No. 13/097,873, entitled STAPLE CARTRIDGECOMPRISING A RELEASABLE PORTION, now U.S. Pat. No. 8,740,038;

U.S. patent application Ser. No. 13/097,938, entitled STAPLE CARTRIDGECOMPRISING COMPRESSIBLE DISTORTION RESISTANT COMPONENTS, now U.S. Pat.No. 9,016,542;

U.S. patent application Ser. No. 13/097,924, entitled STAPLE CARTRIDGECOMPRISING A TISSUE THICKNESS COMPENSATOR, now U.S. Pat. No. 9,168,038;

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U.S. patent application Ser. No. 13/241,912, entitled STAPLE CARTRIDGEINCLUDING COLLAPSIBLE DECK ARRANGEMENT, now U.S. Pat. No. 9,050,084;

U.S. patent application Ser. No. 13/241,922, entitled SURGICAL STAPLERWITH STATIONARY STAPLE DRIVERS, now U.S. Pat. No. 9,216,019;

U.S. patent application Ser. No. 13/241,637, entitled SURGICALINSTRUMENT WITH TRIGGER ASSEMBLY FOR GENERATING MULTIPLE ACTUATIONMOTIONS, now U.S. Pat. No. 8,789,741;

U.S. patent application Ser. No. 13/241,629, entitled SURGICALINSTRUMENT WITH SELECTIVELY ARTICULATABLE END EFFECTOR, now U.S. PatentApplication Publication No. 2012/0074200;

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U.S. patent application Ser. No. 13/433,103, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING A PLURALITY OF LAYERS, now U.S. Pat. No.9,433,419;

U.S. patent application Ser. No. 13/433,098, entitled EXPANDABLE TISSUETHICKNESS COMPENSATOR, now U.S. Pat. No. 9,301,753;

U.S. patent application Ser. No. 13/433,102, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING A RESERVOIR, now U.S. Pat. No. 9,232,941;

U.S. patent application Ser. No. 13/433,114, entitled RETAINER ASSEMBLYINCLUDING A TISSUE THICKNESS COMPENSATOR, now U.S. Pat. No. 9,386,988;

U.S. patent application Ser. No. 12/433,136, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING AT LEAST ONE MEDICAMENT, now U.S. Pat. No.8,533,784;

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U.S. patent application Ser. No. 13/433,144, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING FIBERS TO PRODUCE A RESILIENT LOAD, now U.S. Pat.No. 9,277,919;

U.S. patent application Ser. No. 13/433,148, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING STRUCTURE TO PRODUCE A RESILIENT LOAD, now U.S.Pat. No. 9,220,500;

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U.S. patent application Ser. No. 13/433,167, entitled TISSUE THICKNESSCOMPENSATORS, now U.S. Pat. No. 9,220,501;

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U.S. patent application Ser. No. 13/433,135, entitled MOVABLE MEMBER FORUSE WITH A TISSUE THICKNESS COMPENSATOR, now U.S. Pat. No. 9,517,063;

U.S. patent application Ser. No. 13/433,140, entitled TISSUE THICKNESSCOMPENSATOR AND METHOD FOR MAKING THE SAME, now U.S. Pat. No. 9,241,714;

U.S. patent application Ser. No. 13/433,147, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING CHANNELS, now U.S. Pat. No. 9,351,730;

U.S. patent application Ser. No. 13/433,126, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING TISSUE INGROWTH FEATURES, now U.S. Pat. No.9,320,523;

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U.S. patent application Ser. No. 13/433,129, entitled TISSUE THICKNESSCOMPENSATOR COMPRISING A PLURALITY OF MEDICAMENTS, now U.S. Pat. No.9,211,120.

The Applicant of the present application also owns the U.S. patentapplications identified below which are each herein incorporated byreference in their respective entirety:

U.S. patent application Ser. No. 11/216,562, entitled STAPLE CARTRIDGESFOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S.Pat. No. 7,669,746;

U.S. patent application Ser. No. 11/714,049, entitled SURGICAL STAPLINGDEVICE WITH ANVIL HAVING STAPLE FORMING POCKETS OF VARYING DEPTHS, nowU.S. Patent Application Publication No. 2007/0194082;

U.S. patent application Ser. No. 11/711,979, entitled SURGICAL STAPLINGDEVICES THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S.Pat. No. 8,317,070;

U.S. patent application Ser. No. 11/711,975, entitled SURGICAL STAPLINGDEVICE WITH STAPLE DRIVERS OF DIFFERENT HEIGHT, now U.S. PatentApplication Publication No. 2007/0194079;

U.S. patent application Ser. No. 11/711,977, entitled SURGICAL STAPLINGDEVICE WITH STAPLE DRIVER THAT SUPPORTS MULTIPLE WIRE DIAMETER STAPLES,now U.S. Pat. No. 7,673,781;

U.S. patent application Ser. No. 11/712,315, entitled SURGICAL STAPLINGDEVICE WITH MULTIPLE STACKED ACTUATOR WEDGE CAMS FOR DRIVING STAPLEDRIVERS, now U.S. Pat. No. 7,500,979;

U.S. patent application Ser. No. 12/038,939, entitled STAPLE CARTRIDGESFOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S.Pat. No. 7,934,630;

U.S. patent application Ser. No. 13/020,263, entitled SURGICAL STAPLINGSYSTEMS THAT PRODUCE FORMED STAPLES HAVING DIFFERENT LENGTHS, now U.S.Pat. No. 8,636,187;

U.S. patent application Ser. No. 13/118,278, entitledROBOTICALLY-CONTROLLED SURGICAL STAPLING DEVICES THAT PRODUCE FORMEDSTAPLES HAVING DIFFERENT LENGTHS, now U.S. Pat. No. 9,237,891;

U.S. patent application Ser. No. 13/369,629, entitledROBOTICALLY-CONTROLLED CABLE-BASED SURGICAL END EFFECTORS, now U.S. Pat.No. 8,800,838;

U.S. patent application Ser. No. 12/695,359, entitled SURGICAL STAPLINGDEVICES FOR FORMING STAPLES WITH DIFFERENT FORMED HEIGHTS, now U.S. Pat.No. 8,464,923; and

U.S. patent application Ser. No. 13/072,923, entitled STAPLE CARTRIDGESFOR FORMING STAPLES HAVING DIFFERING FORMED STAPLE HEIGHTS, now U.S.Pat. No. 8,567,656.

The Applicant of the present application also owns the U.S. patentapplications identified below which were filed on Feb. 8, 2013, andwhich are each herein incorporated by reference in their respectiveentirety:

U.S. patent application Ser. No. 13/763,112, entitled SURGICAL STAPLINGCARTRIDGE WITH LAYER RETENTION FEATURES, now U.S. Patent ApplicationPublication No. 2013/0256379;

U.S. patent application Ser. No. 13/763,028, entitled ADHESIVE FILMLAMINATE, now U.S. Pat. No. 9,282,962;

U.S. patent application Ser. No. 13/763,035, entitled ACTUATOR FORRELEASING A TISSUE THICKNESS COMPENSATOR FROM A FASTENER CARTRIDGE, nowU.S. Patent Application Publication No. 2013/0214030;

U.S. patent application Ser. No. 13/763,042, entitled RELEASABLE TISSUETHICKNESS COMPENSATOR AND FASTENER CARTRIDGE HAVING THE SAME, now U.S.Patent Application Publication No. 2013/0221063;

U.S. patent application Ser. No. 13/763,048, entitled FASTENER CARTRIDGECOMPRISING A RELEASABLE TISSUE THICKNESS COMPENSATOR, now U.S. Pat. No.9,700,317;

U.S. patent application Ser. No. 13/763,054, entitled FASTENER CARTRIDGECOMPRISING A CUTTING MEMBER FOR RELEASING A TISSUE THICKNESSCOMPENSATOR, now U.S. Pat. No. 9,272,406;

U.S. patent application Ser. No. 13/763,065, entitled FASTENER CARTRIDGECOMPRISING A RELEASABLY ATTACHED TISSUE THICKNESS COMPENSATOR, now U.S.Pat. No. 9,566,061;

U.S. patent application Ser. No. 13/763,021, entitled STAPLE CARTRIDGECOMPRISING A RELEASABLE COVER, now U.S. Pat. No. 9,386,984;

U.S. patent application Ser. No. 13/763,078, entitled ANVIL LAYERATTACHED TO A PROXIMAL END OF AN END EFFECTOR, now U.S. PatentApplication Publication No. 2013/0256383;

U.S. patent application Ser. No. 13/763,094, entitled LAYER COMPRISINGDEPLOYABLE ATTACHMENT MEMBERS, now U.S. Patent Application PublicationNo. 2013/0256377;

U.S. patent application Ser. No. 13/763,106, entitled END EFFECTORCOMPRISING A DISTAL TISSUE ABUTMENT MEMBER, now U.S. Pat. No. 9,592,050;

U.S. patent application Ser. No. 13/763,147, entitled IMPLANTABLEARRANGEMENTS FOR SURGICAL STAPLE CARTRIDGES, now U.S. Patent ApplicationPublication No. 2013/0153636;

U.S. patent application Ser. No. 13/763,192 entitled MULTIPLE THICKNESSIMPLANTABLE LAYERS FOR SURGICAL STAPLING DEVICES, now U.S. Pat. No.9,615,826;

U.S. patent application Ser. No. 13/763,161, entitled RELEASABLE LAYEROF MATERIAL AND SURGICAL END EFFECTOR HAVING THE SAME, now U.S. PatentApplication Publication No. 2013/0153641;

U.S. patent application Ser. No. 13/763,177 entitled ACTUATOR FORRELEASING A LAYER OF MATERIAL FROM A SURGICAL END EFFECTOR, now U.S.Pat. No. 9,585,657; and

U.S. patent application Ser. No. 13/763,037, entitled STAPLE CARTRIDGECOMPRISING A COMPRESSIBLE PORTION, now U.S. Patent ApplicationPublication No. 2014/0224857.

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those of ordinary skill in the art will understand that thedevices and methods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the various embodiments of the present invention is definedsolely by the claims. The features illustrated or described inconnection with one exemplary embodiment may be combined with thefeatures of other embodiments. Such modifications and variations areintended to be included within the scope of the present invention.

Reference throughout the specification to “various embodiments,” “someembodiments,” “one embodiment,” or “an embodiment”, or the like, meansthat a particular feature, structure, or characteristic described inconnection with the embodiment is included in at least one embodiment.Thus, appearances of the phrases “in various embodiments,” “in someembodiments,” “in one embodiment”, or “in an embodiment”, or the like,in places throughout the specification are not necessarily all referringto the same embodiment. Furthermore, the particular features,structures, or characteristics may be combined in any suitable manner inone or more embodiments. Thus, the particular features, structures, orcharacteristics illustrated or described in connection with oneembodiment may be combined, in whole or in part, with the featuresstructures, or characteristics of one or more other embodiments withoutlimitation. Such modifications and variations are intended to beincluded within the scope of the present invention.

The terms “proximal” and “distal” are used herein with reference to aclinician manipulating the handle portion of the surgical instrument.The term “proximal” referring to the portion closest to the clinicianand the term “distal” referring to the portion located away from theclinician. It will be further appreciated that, for convenience andclarity, spatial terms such as “vertical”, “horizontal”, “up”, and“down” may be used herein with respect to the drawings. However,surgical instruments are used in many orientations and positions, andthese terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performinglaparoscopic and minimally invasive surgical procedures. However, theperson of ordinary skill in the art will readily appreciate that thevarious methods and devices disclosed herein can be used in numeroussurgical procedures and applications including, for example, inconnection with open surgical procedures. As the present DetailedDescription proceeds, those of ordinary skill in the art will furtherappreciate that the various instruments disclosed herein can be insertedinto a body in any way, such as through a natural orifice, through anincision or puncture hole formed in tissue, etc. The working portions orend effector portions of the instruments can be inserted directly into apatient's body or can be inserted through an access device that has aworking channel through which the end effector and elongated shaft of asurgical instrument can be advanced.

In various embodiments, a surgical stapling instrument, such asinstrument 10, for example, can comprise a handle, a shaft extendingfrom the handle, and an end effector extending from the shaft which canbe configured to treat the tissue of a patient. Referring to FIG. 1,handle assembly 12 of instrument 10 can be attached to a first, orproximal, end 13 of an instrument shaft 16 and, additionally, an endeffector assembly 14 can be configured to be attached to a second, ordistal, end 15 of instrument shaft 16. In various embodiments, endeffector assembly 14 and at least a portion of instrument shaft 16 canbe configured to be positioned within, and inserted at least partiallythrough, a cannula, or trocar, in a patient's body during a minimallyinvasive surgical procedure. Various surgical instruments are describedin further detail in U.S. patent application Ser. No. 11/329,020,entitled SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR, whichwas filed on Jan. 10, 2006; U.S. patent application Ser. No. 11/343,321,entitled SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGERLOCKING MECHANISM, which was filed on Jan. 31, 2006; and U.S. patentapplication Ser. No. 11/529,935, entitled SURGICAL STAPLES HAVINGATTACHED DRIVERS AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME, whichwas filed on Sep. 29, 2006, the entire disclosures of which are herebyincorporated by reference herein.

In various embodiments, further to the above, the end effector assembly14 can include a first jaw member 20 and a second jaw member 424 whereinat least one of the first and second jaw members can be configured to bemoved relative to the other jaw member such that the tissue of a patientcan be clamped therebetween. Referring to FIGS. 1-3 and 5, first jawmember 20 can include staple cartridge 422 and, additionally, second jawmember 424 can include anvil 426. In at least one embodiment, staplecartridge 422 can include a deck having a plurality of staple cavitiesdefined therein. Anvil 426 can include an anvil cover 427 and an anvilface, wherein the anvil face can have a plurality of anvil pocketsdefined therein. In various embodiments, each staple cavity can beconfigured to removably store a staple therein and each anvil pocket canbe configured to deform at least a portion of the staple as the stapleis deployed. In various embodiments, at least one of the staplecartridge and the anvil can comprise one or more gripping features, orridges, 435 which can be configured to hold the tissue within the endeffector.

Further to the above, end effector assembly 14 can include at least onepiece of buttress material 436 and/or 436′ which can be configured to bepositioned intermediate the first and second jaw members and can bereleasably retained to one of the cartridge deck and/or the anvil face,for example. In at least one embodiment, a surface on the piece ofbuttress material can be configured to contact tissue as the tissue isclamped between the first and second jaw members. In such an embodiment,the buttress material surface can be used to distribute the compressiveclamping force over the tissue, remove excess fluid from the tissue,and/or improve the purchase of the staples. In various embodiments, oneor more pieces of buttress material can be positioned within the endeffector assembly. In at least one embodiment, one piece of buttressmaterial 436 can be attached to staple cartridge 422 and one piece ofbuttress material 436′ can be attached to anvil 426. In at least oneother embodiment, two pieces of buttress material 436 can be positionedon the cartridge deck and one piece of buttress material 436′ can bepositioned on the anvil face, for example. In other various embodiments,any suitable number of pieces of buttress material can be situatedwithin an end effector assembly. In any event, in various embodiments,the piece(s) of buttress material can be comprised of a material suchas, a bioabsorbable material, a biofragmentable material, and/or adissolvable material, for example, such that the buttress material canbe absorbed, fragmented, and/or dissolved during the healing process. Inat least one embodiment, the piece(s) of buttress material can be atleast partially comprised of a therapeutic drug which can be configuredto be released over time to aid the tissue in healing, for example. Infurther various embodiments, the piece(s) of buttress material caninclude a non-absorbable and/or non-dissolvable material, for example.

In various embodiments, an end effector assembly can include at leastone connection member or fastener, such as connection members 38, forexample, which can be utilized to releasably retain a piece of buttressmaterial to at least one of an anvil and a staple cartridge, forexample. In various embodiments, connection members can be configured tobe released from an end effector and deployed along with a piece ofbuttress material. In at least one embodiment, head portions of theconnection members can be configured to be separated from body portionsof the connection members such that the head portions can be deployedwith the piece of buttress material while the body portions remainattached to the end effector. In other various embodiments, the entiretyof the connection members can remain engaged with the end effector whenthe piece of buttress material is detached from the end effector. In anyevent, in at least one embodiment, the connection members can be atleast partially comprised of at least one of a bioabsorbable material, abiofragmentable material, and a dissolvable material such that theconnection members can be absorbed, fragmented, and/or dissolved withinthe body. In various embodiments, the connection members comprised of atherapeutic drug which can be configured to be released over time to aidthe tissue in healing, for example. In further various embodiments, theconnection members can include a non-absorbable and/or non-dissolvablematerial, for example, such as a plastic.

In various embodiments, the connection members can be arranged in anysuitable pattern or configuration. In at least one embodiment, theconnection members can be situated around the outer perimeter of pieceof buttress material 436, for example. In at least one embodiment, theconnection members can be positioned proximate to one or more sidesand/or ends of the piece of buttress material, for example, to prevent,or at least assist in preventing, the buttress material from peelingaway from the staple cartridge deck and/or the anvil face when the endeffector is inserted through a trocar or engaged with tissue. In variousembodiments, the connection members can be used in conjunction with anysuitable adhesive, such as cyanoacrilate, for example, to releasablyretain the piece of buttress material, or at least a portion of thebuttress material, to the end effector. In at least one embodiment, theadhesive can be applied to connection members prior to the connectionmembers being engaged with the apertures in the piece of buttressmaterial, staple cartridge, and/or anvil.

Referring to FIG. 4, a retention member can be configured to be movedwithin an end effector between a first position and a second position toreleasably retain a tissue thickness compensator to the end effector. Anend effector assembly 214 can include a first jaw including staplecartridge 222 and a second jaw including anvil 226 wherein retentionmember 262 can be moved relative to staple cartridge 222 and anvil 226.For example, retention member 262 can be moved between a first, orextended, position near distal end 264 to a second, or retracted,position near proximal end 263. In its extended position, retentionmember 262 can hold a tissue thickness compensator such as, for example,tissue thickness compensator 236 in position as end effector 214 isinserted into a surgical site. Thereafter, end effector 214 can beclosed onto tissue, for example, and staples can be deployed through thecompensator 236 into the tissue. Retention member 262 can be moved intoits retracted position such that retention member 262 can be operablydisengaged from compensator 236. Alternatively, retention member 262 canbe retracted prior to the staples being deployed. In any event, as aresult of the above, end effector 214 can be opened and withdrawn fromthe surgical site leaving behind the stapled compensator 236 and tissue.

In various embodiments, referring to FIGS. 6 and 7, at least oneresilient member can be utilized to releasably retain a piece ofbuttress material to a staple cartridge and/or anvil of an end effector.Similar to the above, a first jaw 520 of the end effector can comprise astaple cartridge 522 and a second jaw 524 can comprise an anvil 526. Inat least one embodiment, at least one resilient member, such asresilient members 550 or 550′, for example, can include a first end,such as first ends 552 or 552′, configured to be attached to, orintegrally formed with, at least one of first and second jaw members 520and 524. In at least one embodiment, each resilient member 550 caninclude a second end, such as second ends 554 or 554′, for example,configured to contact and releasably retain a piece of buttressmaterial, such as piece of buttress material 536, for example, to atleast one of the first and second jaw members. In various embodiments,second end 554 can include tip 558 which can be configured to grip atleast a portion of piece of buttress material 536, for example. Invarious embodiments, tip 558 can be contoured and/or configured toinclude a rough or ribbed surface, for example, in order to frictionallyengage the piece of buttress material. Similarly, each second end 554′can comprise a tip 558′configured to engage and hold a piece of buttressmaterial to the anvil.

In various embodiments, referring again to FIGS. 6 and 7, a plurality ofresilient members can be provided on at least two sides of a jaw memberto retain side portions of the piece of buttress material to the jawmember. In at least one embodiment, first ends 552 of each individualresilient member 550 can be attached to one another by a connectingmember, such as connecting member, or bar, 556 or 556′, for example. Invarious embodiments, connecting member 556 can be attached to second jawmember 524 such that connection member 556 can provide support toresilient members 550. In other various embodiments, a plurality ofresilient members 550 can be attached to at least one of the first andsecond jaw members without the use of a connecting member. In such anembodiment, the first ends of the resilient members can be attacheddirectly to one of the first and second jaw members, for example. In atleast one embodiment, resilient members 550, for example, can beconfigured to release buttress material 536 after staples have beendeployed through the buttress material and/or when the buttress materialis disengaged from the end effector. In at least one embodiment, theresilient members can be comprised of an elastic material such as metalor plastic, for example.

As outlined above, an end effector assembly can include a staplecartridge, an anvil, and at least one piece of buttress materialpositioned intermediate the staple cartridge and the anvil. In at leastone embodiment, referring to FIG. 8, a piece of buttress material, suchas buttress material 336, can be configured to be snap-fit to at leastone of staple cartridge 322 and/or an anvil to releasably retain thepiece of buttress material within the end effector. The staple cartridge322 can include first side wall 302 and a second side wall opposite thefirst side wall 302, wherein at least one of the first and second sidewalls can include a lip 306 extending outwardly therefrom. In variousembodiments, buttress material 336 can include first edge, or side, 308,second edge, or side, 310, and at least one lip 312 extending at leastpartially along the length of edges 308 and 310. In at least oneembodiment, lips 312 can be configured to engage lips 306 in a snap-fitfashion in order to releasably retain buttress material 336 to staplecartridge 322.

Further to the above, buttress material 336 can include surface 316which can be configured to be positioned adjacent to or against deck 328of staple cartridge 322. In at least one embodiment, side edges 308 and310 can comprise sidewalls which can extend in a perpendicular ortransverse direction relative to surface 316. In such embodiments, lips312 can extend from these sidewalls such that lips 312 can beinterlocked behind lips 306 of staple cartridge 322. In variousembodiments, lips 312 of buttress material 336 can be disengaged fromlips 306 of staple cartridge 322 when the staples are deployed fromstaple cartridge 322. More particularly, when the staples are deployed,the staples can contact buttress material 336, apply an upward force tobuttress material 336, and dislodge buttress material 336 from staplecartridge 322. Advantageously, as a result, buttress material 336 may beautomatically disengaged from staple cartridge 322 when the staples aredeployed therefrom and/or when the end effector is opened as describedabove.

In various embodiments, a piece of buttress material can include atleast one member extending therefrom which can be configured toreleasably retain the buttress material to one of a staple cartridgeand/or an anvil. In at least one embodiment, one or more members 318 canextend from buttress material 336 in a direction which is perpendicularor transverse to surface 316. In various embodiments, each member 318can be engaged with a staple cavity 320 defined in the deck 328 in afriction-fit or press-fit manner to releasably retain the piece ofbuttress material 336 to the staple cartridge. In certain embodiments, apiece of buttress material can comprise members which engage pockets inthe anvil. Similar to the above, in various embodiments, staplesdeployed from staple cavities 320 can apply an upward force to buttressmaterial 336 and disengage members 318 from staple cavities 320. Invarious embodiments, the staples can pierce projections 318 and/orbuttress material 336 to secure the buttress material to the tissue asoutlined above.

As illustrated in FIG. 8, a piece of buttress material can include morethan one member, or projection, extending therefrom to retain a piece ofbuttress material to one of a staple cartridge and an anvil. In variousembodiments, referring to FIGS. 9 and 10, more than one member 318′ canextend from piece of buttress material 336′, for example. In at leastone embodiment, members 318′ can be can press-fit into staple cavities320′ of staple cartridge 322′, and/or into anvil pockets of an anvil(not illustrated), such that the members can frictionally retain thepiece of buttress material to the staple cartridge and/or the anvil asoutlined above. In various embodiments, a staple cartridge can includeslots or apertures therein in addition to the staple cavities defined inthe staple cartridge which can be configured to frictionally receive themembers 318′. Likewise, in various embodiments, an anvil can includeslots or apertures therein in addition to the staple forming pocketsdefined therein which can be configured to frictionally receive themembers 318′.

FIGS. 11 and 28 illustrate one embodiment of a surgical staplinginstrument. Briefly, the surgical stapling instrument includes a handleassembly 12 and an elongated shaft 14. A disposable loading unit or DLU16 is releasably secured to a distal end of the shaft 14. Disposableloading unit 16 includes a tool assembly 17 having a cartridge assembly18 housing, a plurality of surgical staples, and an anvil assembly 20movably secured in relation to cartridge assembly 18. Disposable loadingunit 16 is configured to apply linear rows of staples measuring fromabout 30 mm to about 60 mm in length. Disposable loading units havinglinear rows of staples of other lengths are also envisioned, e.g., 45mm. Handle assembly 12 includes a stationary handle member 22, a movablehandle member 24, and a barrel portion 26. A rotatable member 28 ismounted on the forward end of barrel portion 26 to facilitate rotationof elongated body 14 with respect to handle assembly 12. An articulationlever 30 is also mounted on the forward end of barrel portion 26adjacent rotatable knob 28 to facilitate the articulation of toolassembly 17. A pair of retraction knobs 32 are movably positioned alongbarrel portion 26 to return surgical stapling apparatus 10 to aretracted position, as will be described in detail below.

Handle assembly 12 includes a housing which is formed from moldedhousing half-sections 36 a and 36 b, which forms stationary handlemember 22 and barrel portion 26 of handle assembly 12 (See FIG. 1).Movable handle member 24 is pivotably supported between housinghalf-sections 36 a and 36 b about pivot pin 38. A biasing member 40,which is a torsion spring, biases movable handle 24 away from stationaryhandle 22. An actuation shaft 46 is supported within barrel portion 26of housing 36 and includes a toothed rack 48. A driving pawl 42 having arack engagement finger 43 with laterally extending wings 43 a and 43 bis pivotably mounted to one end of movable handle 24 about a pivot pin44. A biasing member 50, which is also a torsion spring, is positionedto urge engagement finger 43 of driving pawl 42 towards toothed rack 48of actuation shaft 46. Movable handle 24 is pivotable to move engagementfinger 43 of driving pawl 42 into contact with toothed rack 48 ofactuation shaft 46 to advance the actuation shaft linearly in the distaldirection. The forward end of actuation shaft 46 rotatably receives theproximal end 49 of a control rod 52 such that linear advancement ofactuation shaft 46 causes corresponding linear advancement of controlrod 52. A locking pawl 54 having a rack engagement member 55 ispivotably mounted within housing 36 about pivot pin 57 and is biasedtowards toothed rack 48 by biasing member 56, which is also a torsionspring. Engagement member 55 of locking pawl 54 is movable intoengagement with toothed rack 48 to retain actuation shaft 46 in alongitudinally fixed position.

A retraction mechanism 58, which includes a pair of retractor knobs 32,is connected to the proximal end of actuation shaft 46 by a coupling rod60. Coupling rod 60 includes right and left engagement portions 62 a and62 b for receiving retractor knobs 32 and a central portion 62 c whichis dimensioned and configured to translate within a pair of longitudinalslots 34 a formed in actuation shaft 46 adjacent the proximal endthereof. A release plate 64 is operatively associated with actuationshaft 46 and is mounted for movement with respect thereto in response tomanipulation of retractor knobs 32. A pair of spaced apart pins 66extend outwardly from a lateral face of actuation shaft 46 to engage apair of corresponding angled cam slots 68 formed in release plate 64.Upon rearward movement of retractor knobs 32, pins 66 can release plate64 downwardly with respect to actuation shaft 46 and with respect totoothed rack 48 such that the bottom portion of release plate 64 extendsbelow toothed rack 48 to disengage engagement finger 43 of driving pawl42 from toothed rack 48. A transverse slot 70 is formed at the proximalend of release plate 64 to accommodate the central portion 62 c ofcoupling rod 60, and elongated slots 34 (See FIG. 1) are defined in thebarrel section 26 of handle assembly 12 to accommodate the longitudinaltranslation of coupling rod 60 as retraction knobs 32 are pulledrearwardly to retract actuation shaft 46 and thus retract control rod 52rearwardly. Actuation shaft 46 is biased proximally by spring 72 whichis secured at one end to coupling rod portion 62 via connector 74 and atthe other end to post 76 on actuation shaft 46.

Further to the above, handle assembly 12 includes a firing lockoutassembly 80 which includes a plunger 82 and a pivotable locking member83. Plunger 82 is biased to a central position by biasing springs 84 andincludes annular tapered camming surfaces 85. Each end of plunger 82extends through housing 36 adjacent an upper end of stationary handle22. Pivotable locking member 83 is pivotably attached at its distal endbetween housing half-sections 36 a and 36 b about pivot pin 86 andincludes a locking surface 88 and proximal extension 90 having a slot 89formed therein. Locking member 83 is biased by spring 92counter-clockwise (as viewed in FIG. 11) to move locking surface 88 to aposition to abut the distal end of actuation shaft 46 to preventadvancement of shaft 46 and subsequent firing of the stapling apparatus.Annular tapered camming surface 85 is positioned to extend into taperedslot 89 in proximal extension 90. Lateral movement of plunger 82 ineither direction against the bias of either spring 84 moves taperedcamming surface 85 into engagement with the sidewalls of tapered slot 89to pivot locking member 83 clockwise about pivot pin 86, as viewed inFIG. 11, to move blocking surface 88 to a position to permit advancementof actuation shaft 46 and thus firing of stapling apparatus 10. Blockingsurface 88 is retained in this position by recesses which receive thetapered tip of camming surface 85 to lock locking member 83 in acounter-clockwise position. Operation of firing lockout assembly 80 willbe further illustrated below.

Further to the above, handle mechanism 12 also includes an anti-reverseclutch mechanism which includes a first gear 94 rotatably mounted on afirst shaft 96, and second gear 98 mounted on a second shaft 100, and aslide plate (not illustrated) slidably mounted within housing 36. Theslide plate includes an elongated slot dimensioned and configured to beslidably positioned about locking pawl pivot pin 57, a gear plateconfigured to mesh with the teeth of second gear 98, and a cam surface.In the retracted position, the cam surface of the slide plate engageslocking pawl 54 to prevent locking pawl 54 from engaging toothed rack48. Actuation shaft 46 includes a distal set of gear teeth spaced fromthe proximal set of gear teeth positioned to engage first gear 94 ofactuation shaft 46 during movement of actuation shaft 46. When actuationshaft 46 is advanced by pivoting movable handle 24 about pivot pin 38,the distal gear teeth on actuation shaft 46 mesh with and rotate firstgear 94 and first shaft 96. First shaft 96 is connected to second shaft100 by spring clutch assembly such that rotation of first shaft 96 willcause corresponding rotation of second shaft 100. Rotation of secondshaft 100 causes corresponding rotation of second gear 98 which isengaged with the gear plate on the slide plate to cause linearadvancement of the slide plate. Linear advancement of the slide plate islimited to the length of elongated slot. When the slide plate has beenadvanced the length of the slot, the cam surface releases locking pawl54 such that it is moved into engagement with toothed rack 48. Continuedadvancement of actuation shaft 46 eventually moves the distal gear teethinto engagement with the gear plate. However, since the slide plate islongitudinally fixed in position, the spring clutch is forced torelease, such that continued distal advancement of actuation shaft 46 ispermitted.

When actuation shaft 46 is returned to the retracted position (bypulling retraction knobs 34 proximally, as discussed above) the distalgear teeth engage first gear 94 to rotate second gear 98 in the reversedirection to retract the slide member proximally within housing 36.Proximal movement of the slide member advances the cam surface intolocking pawl 54 prior to engagement between locking pawl 54 and toothedrack 48 to urge locking pawl 54 to a position to permit retraction ofactuation shaft 46.

Referring again to FIG. 11, handle assembly 12 includes an emergencyreturn button 112 pivotally mounted within housing 36 about a pivotmember 114 supported between housing half-sections 36 a and 36 b. Returnbutton 112 includes an externally positioned member 116 positioned onthe proximal end of barrel portion 26. Member 116 is movable about pivotmember 114 into engagement with the proximal end of locking pawl 54 tourge rack engagement member 55 out of engagement with toothed rack 48 topermit retraction of actuation shaft 46 during the firing stroke of thestapling apparatus 10.

As discussed above, during the clamping portion of advancement ofactuation shaft 46, the slide plate disengages pawl 54 from rack 48 andthus actuation of return button 112 is not necessary to retract theactuation shaft 46. FIGS. 12-14 illustrate the interconnection ofelongated body 14 and handle assembly 12. Housing 36 includes an annularchannel 117 configured to receive an annular rib 118 formed on theproximal end of rotation member 28, which is formed from moldedhalf-sections 28 a and 28 b. Annular channel 117 and rib 118 permitrelative rotation between rotation member 28 and housing 36. Elongatedbody 14 includes inner housing 122 and an outer casing 124. Innerhousing 122 is dimensioned to be received within outer casing 124 andincludes an internal bore 126 which extends therethrough and isdimensioned to slidably receive a first articulation link 123 andcontrol rod 52. The proximal end of housing 122 and casing 124 eachinclude a pair of diametrically opposed openings 130 and 128,respectively, which are dimensioned to receive radial projections 132formed on the distal end of rotation member 28. Projections 132 andopenings 128 and 130 fixedly secure rotation member 28 and elongatedbody 14 in relation to each other, both longitudinally and rotatably.Rotation of rotation knob 28 with respect to handle assembly 12 thusresults in corresponding rotation of elongated body 14 with respect tohandle assembly 12.

An articulation mechanism 120 is supported on rotatable member 28 andincludes articulation lever 30, a cam member 136, a translation member138, and the first articulation link 123. Articulation lever 30 ispivotably mounted about pivot member 140 which extends outwardly fromrotation member 28 and is formed integrally therewith. A projection 142extends downwardly from articulation lever 30 for engagement with cammember 136. The distal end of translation member 138 includes arm 160which includes an opening 162 configured to receive a finger 164extending from the proximal end of articulation link 123. A pin 166having a housing 168 constructed from a non-abrasive material, e.g.,Teflon, is secured to translation member 138 and dimensioned to bereceived within a stepped camming surface. In an assembled condition,proximal and distal stepped portions 150 and 152 of cam member 136 arepositioned beneath flanges, such as flange 170, formed on rotationmember 28 to restrict cam member 136 to transverse movement with respectto the longitudinal axis of stapling apparatus 10. When articulationlever 30 is pivoted about pivot member 140, cam member 136 is movedtransversely on rotation member 28 to move stepped camming surface 148transversely relative to pin 166, forcing pin 166 to move proximally ordistally along stepped cam surface 148. Since pin 166 is fixedlyattached to translation member 138, translation member 138 is movedproximally or distally to effect corresponding proximal or distalmovement of first actuation link 123.

A disposable loading unit sensing mechanism extends within the staplinginstrument from elongated body 14 into handle assembly 12. The sensingmechanism includes a sensor tube 176 which is slidably supported withinbore 26 of elongated body 14. The distal end of sensor tube 176 ispositioned towards the distal end of elongated body 14 and the proximalend of sensor tube 176 is secured within the distal end of a sensorcylinder 178 via a pair of nubs 180. The distal end of a sensor link 182is secured to the proximal end of sensor cylinder 178. Sensor link 182has a bulbous end 184 which engages a camming surface on pivotablelocking member 83. When a disposable loading unit is inserted in thedistal end of elongated body 14, the disposable loading unit engages thedistal end of sensor tube 176 to drive sensor tube 176 proximally, andthereby drive sensor cylinder 178 and sensor link 182 proximally.Movement of sensor link 182 proximally causes bulbous end 184 of sensorlink 182 to move distally of the camming surface to allow locking member83 to pivot under the bias of spring 92 from a position permittingfiring of stapling apparatus 10 to a blocking position, wherein blockingmember 83 is positioned to engage actuation shaft 46 and prevent firingof stapling apparatus 10. Sensor link 182 and locking member 83 functionto prevent firing of surgical stapling apparatus 10 after a disposableloading unit has been secured to elongated body 14, without firstoperating firing lockout assembly 80.

Further to the above, cam member 136 can include a recess defined in thebottom portion thereof. A locking ring 184 having a nub portion 186configured to be received within this recess can be positioned aboutsensor cylinder 178 between a control tab portion 188 and a proximalflange portion 190. A spring 192 positioned between flange portion 190and locking ring 184 urges locking ring distally about sensor cylinder178. When an articulating disposable loading unit having an extendedinsertion tip 193 (FIG. 16) is inserted into the distal end of elongatedbody 14 of stapling apparatus 10, insertion tip 193 causes tab portion188 to move proximally into engagement with locking ring 184 to urgelocking ring 184 and nub 186 proximally of recess 154 in cam member 136.With nub 186 positioned proximally of the recess in cam member 136, thecam member 136 is free to move transversely to effect articulation ofstapling apparatus 10. A non-articulating disposable loading unit maynot have an extended insertion tip. As such, when a non-articulatingdisposable loading unit is inserted in elongated body 14, sensorcylinder 178 is not retracted proximally a sufficient distance to movenub 186 from recess 154. Thus, cam member 136 is prevented from movingtransversely by nub 186 of locking ring 184 which is positioned in therecess defined in the cam member 136 and articulation lever 30 is lockedin its central position.

Referring to FIGS. 15-18, a disposable loading unit, such as disposableloading unit 16 a and/or 16 b, for example, includes a proximal housingportion 200 adapted to releasably engage the distal end of body portion14. A mounting assembly 202 is pivotally secured to the distal end ofhousing portion 200, and is configured to receive the proximal end oftool assembly 17 such that pivotal movement of mounting assembly 202about an axis perpendicular to the longitudinal axis of housing portion200 effects articulation of tool assembly 17 about pivot pin 244.Housing portion 200 of disposable loading unit 16 can include, one,engagement nubs 254 for releasably engaging elongated shaft 14 and, two,an insertion tip 193. Nubs 254 form a bayonet type coupling with thedistal end of shaft 14. A second articulation link is dimensioned to beslidably positioned within a slot 258 formed between housing halves ofhousing portion 200.

Referring to FIGS. 19-27, tool assembly 17 includes anvil assembly 20and cartridge assembly 18. Anvil assembly 20 includes anvil portion 204having a plurality of staple deforming concavities 206 and a cover plate208 secured to a top surface of anvil portion 204 to define a cavity 210therebetween. Cover plate 208 is provided to prevent pinching of tissueduring clamping and firing of the surgical stapling apparatus. Cavity210 is dimensioned to receive a distal end of an axial drive assembly212. A longitudinal slot 214 extends through anvil portion 204 tofacilitate passage of retention flange 284 of axial drive assembly 212into the anvil cavity 210. A camming surface 209 formed on anvil portion204 is positioned to engage axial drive assembly 212 to facilitateclamping of tissue 198. A pair of pivot members 211 formed on anvilportion 204 are positioned within slots 213 formed in carrier 216 toguide the anvil portion between the open and clamped positions. A pairof stabilizing members can engage a respective shoulder 217 formed oncarrier 216 to prevent anvil portion 204 from sliding axially relativeto staple cartridge 220 as camming surface 209 is deformed.

Cartridge assembly 18 includes a carrier 216 which defines an elongatedsupport channel 218. Elongated support channel 218 is dimensioned andconfigured to receive a staple cartridge 220. Corresponding tabs 222 andslots 224 formed along staple cartridge 220 and elongated supportchannel 218 function to retain staple cartridge 220 within supportchannel 218. A pair of support struts 223 formed on staple cartridge 220are positioned to rest on side walls of carrier 216 to further stabilizestaple cartridge 220 within support channel 218. Staple cartridge 220includes retention slots 225 for receiving a plurality of fasteners 226and pushers 228. A plurality of spaced apart longitudinal slots 230extend through staple cartridge 220 to accommodate upstanding cam wedges232 of actuation sled 234. A central longitudinal slot 282 extends alongthe length of staple cartridge 220 to facilitate passage of a knifeblade 280. During operation of the surgical stapler, actuation sled 234translates through longitudinal slots 230 of staple cartridge 220 toadvance cam wedges 232 into sequential contact with pushers 228, tocause pushers 228 to translate vertically within slots 225 and urgefasteners 226 from slots 225 into the staple deforming cavities 206 ofanvil assembly 20.

Further to the above, the shaft of the surgical stapling instrument caninclude upper and lower mounting portions 236 and 238. Each mountingportion includes a threaded bore 240 on each side thereof dimensioned toreceive threaded bolts 242 for securing the proximal end of carrier 216thereto. A pair of centrally located pivot members 244 extends betweenupper and lower mounting portions via a pair of coupling members whichengage the distal end of housing portion 200. Housing portion 200 of thedisposable loading unit can include upper and lower housing halvescontained within an outer casing 251. A second articulation link 256 isdimensioned to be slidably positioned within a slot formed between thehousing halves. A pair of blow out plates 254 are positioned adjacentthe distal end of housing portion 200 adjacent the distal end of axialdrive assembly 212 to prevent outward bulging of drive assembly 212during articulation of tool assembly 17. The second articulation link256 includes at least one elongated metallic plate. Preferably, two ormore metallic plates are stacked to form link 256. The proximal end ofarticulation link 256 includes a hook portion 258 configured to engagefirst articulation link 123 and the distal end includes a loop 260dimensioned to engage a projection 262 formed on mounting assembly 202.Projection 262 is laterally offset from pivot pin 244 such that linearmovement of second articulation link 256 causes mounting assembly 202 topivot about pivot pins 244 to articulate tool assembly 17.

The distal end of drive beam 266 is defined by a vertical support strut278 which supports a knife blade 280, and an abutment surface 283 whichengages the central portion of actuation sled 234 during a staplingprocedure. Surface 285 at the base of surface 283 is configured toreceive a support member 287 slidably positioned along the bottom of thestaple cartridge 220. Knife blade 280 is positioned to translateslightly behind actuation sled 234 through a central longitudinal slot282 in staple cartridge 220 to form an incision between rows of stapledbody tissue. A retention flange projects distally from the verticalstrut and supports a cylindrical cam roller 286 at its distal end. Camroller 286 is dimensioned and configured to engage cam surface 209 onanvil body 204 to clamp anvil portion 204 against body tissue.

In various embodiments, referring now to FIGS. 30 and 31, an endeffector of a surgical stapling instrument can comprise a first jaw 680including a staple cartridge assembly and a second jaw 670. The firstjaw 680 can include a pan 680 a, a cartridge body 682 positionable inthe pan 680 a, and a sled 690 which is movable through the cartridgebody 682 to lift drivers 692 toward deck 682 a of cartridge body 682 andeject the staples 684 removably stored in staple cavities definedtherein. The cartridge body 682 can further comprise a plurality ofslots 682 b which can each be configured to receive a cam of the sled690, such as cams 690 a-690 c, for example, which can be configured toengage and lift the drivers 692. The staple cartridge assembly canfurther comprise a layer B2 which can be attached to the cartridge body682 utilizing connectors S3 and S4. In various embodiments, eachconnector S3 and S4 can comprise a suture which ties the layer B2 to thecartridge body 682. For instance, the connector S3 can mount the distalend of the layer B2 to the distal end 682 f of the cartridge body 682while the connector S4 can mount the proximal end of the layer B2 to theproximal end 682 e of the cartridge body 682. In use, a cutting member,such as cutting member 660, for example, can be advanced through thecartridge body 682 and incise, or otherwise deactivate, the connectorsS3 and S4. For instance, the cutting member 660 can comprise a body 662,flanges 664 a and 664 b which are configured to engage the second jaw670 and the first jaw 680, respectively, and a cutting member 66 whichis configured to traverse a longitudinal slot 682 c defined in thecartridge body 682 a. The cutting member 660 can be advanced distallythrough the cartridge body 682 by a firing member assembly 650. Thefiring member assembly 650 can comprise a shaft 652 comprised of aplurality of layers including a distal end 654 engaged within thecutting member body 662 and a proximal end 656 configured to receive afiring force applied thereto.

When the firing force is applied to the firing member 650, further tothe above, the flange 664 a can engage the second jaw 670 and pivot thesecond jaw 670 downwardly toward the first jaw 680. The second jaw 670can comprise an anvil assembly 623 which can include a frame 672 and ananvil plate including a plurality of anvil pockets defined therein. Asthe firing member 650 is being advanced distally, the cutting member 660can pass through a longitudinal slot 670 b defined in the anvil plate.Similar to the above, the second jaw 670 can further comprise a layer B1attached thereto by one or more connectors, such as connectors S1 andS2, for example. Also similar to the above, the connectors S1 and S2 caneach comprise a suture, wherein the connector S1 can be configured toreleasably hold the distal end of the layer B1 to the distal end 670 eof the anvil assembly 623 and wherein the connector S2 can be configuredto releasably hold the distal end of the layer B2 to the proximal end670 c of the anvil assembly 623. In various embodiments, the anvilassembly 623 can comprise a distal nose 676 assembled to the frame 672and can include a slot 676 a defined therein which is configured toreceive the connector S1. Similarly, the proximal end of the frame 672can include a slot 672 a defined therein which is configured to receivethe connector S2. In either event, in various embodiments, theconnectors S1 and S2 can extend around the entirety of the anvil frame672 while, in other embodiments, the connectors S1 and S2 can engage thesides of the anvil assembly 623. When the cutting member 660 is advanceddistally through the anvil assembly 623, the cutting member 660 cantransect, or otherwise deactivate, the connectors S1 and S2 to releasethe layer B1 from the anvil assembly 623. More particularly, in variousembodiments, the layer B1 can be positioned on one side of the patienttissue and the layer B2 can be positioned on the opposite side of thepatient tissue, wherein the staples 684 can then be fired through thelayer B2, the patient tissue, and the layer B1 when the firing member650 is advanced distally. As the firing member 650 is advanced distally,the cutting member 660 can progressively transect the connectors S1-S4as the layers B1 and B2 are progressively transected by the cuttingmember 660. For instance, the cutting member 660 can transect connectorsS2 and S4 at the beginning of the stroke and connectors S1 and S3 at theend of the stroke. In various embodiments, referring now to FIGS. 32 and33, an end effector 716 can comprise a first jaw 718 and a second jaw720 wherein a connector 774 can be embedded within a slot 770 e definedin an anvil 772 of the second jaw 720.

Referring to FIG. 33A, an end effector of a surgical stapling instrumentcan comprise a first jaw and a second jaw, wherein at least one of thefirst jaw and the second jaw can be configured to be moved relative tothe other. The end effector can comprise a first jaw including a staplecartridge channel 1050 and a second jaw including an anvil, wherein theanvil can be pivoted toward and/or away from the staple cartridgechannel 1050, for example. In various alternative embodiments, the firstjaw including a staple cartridge thereto can be pivoted toward and/oraway from the second jaw including the anvil. In either event, thestaple cartridge channel 1050 can be configured to receive a staplecartridge 1060, for example, which can be removably retained within thestaple cartridge channel 1050. The staple cartridge 1060 can comprise acartridge body 1062, a cartridge deck 1064, and a tissue thicknesscompensator 1000 wherein, as illustrated in FIG. 33A, tissue thicknesscompensator 1000 may be removably positioned against or adjacentcartridge deck 1064. Similar to other embodiments described herein,referring now to FIGS. 33A and 34, the cartridge body 1062 can comprisea plurality of staple cavities 1066 and a staple 1002 positioned withineach staple cavity 1066. Also similar to other embodiments describedherein, the staples 1002 can be supported by staple drivers positionedwithin the cartridge body 1062 wherein a sled and/or firing member, forexample, can be advanced through the staple cartridge 1060 to lift thestaple drivers upwardly within the staple cavities 1066 and eject thestaples 1002 from the staple cavities 1066.

Referring to FIG. 34, tissue thickness compensators, such as tissuethickness compensators 1000 and 1000′, can be fastened to tissue T inorder, for example, to provide support for fastened tissue T. Asillustrated in FIG. 34, tissue thickness compensators 1000 and 1000′ canbe fastened to opposite sides of tissue T. A tissue thicknesscompensator such as, for example, tissue thickness compensator 1000, maycomprise an inner portion 1004 and an outer portion 1006 which may forman outer perimeter at least partially surrounding the inner portion1004. The outer portion 1006 may be more flexible than the inner portion1004. In various circumstances, the outer portion 1006 may comprisesufficient flexibility to provide an atraumatic tissue contactingsurface for tissue T, and the inner portion may comprise sufficientrigidity to provide adequate support for fastened tissue T.

Referring again to FIG. 34, the outer portion 1006 of tissue thicknesscompensator 1000 may include an outer edge 1008. To improve itsflexibility, the outer portion 1006 may include multiple slits 1010. Inaddition, pieces of the outer edge 1008 and the outer portion 1006 canbe cut or removed to improve the flexibility of the outer portion 1006.As illustrated in FIG. 34, slits 1010 can begin at the outer edge 1008and can follow various paths terminating within the outer portion 1006.For example, a slit, such as slit 1010A, may begin at the outer edge1008 then follow a path substantially perpendicular to the outer edge1008 terminating within the outer portion 1006. In another example, aslit, such as slit 10106, may also begin at the outer edge 1008 thenfollow a path at an acute angle with the outer edge 1008, alsoterminating within the outer portion 1006. Tissue thickness compensator1000 can be manufactured with slits 1010 in the outer portion 1006.Alternatively, tissue thickness compensator 1000 can be manufacturedwithout the slits 1010, which can be incorporated into the outer portion1006 prior to the implantation thereof, for example.

As described above, and as illustrated in FIG. 34, staples 1002 can beconfigured to at least partially capture tissue thickness compensator1000 when the staples 1002 are moved from their unfired positions totheir fired positions. Furthermore, staples 1002 can be fired in rowsand each row may include multiple staples 1002. A row of staples 1002,for example row 1012, can be fastened onto the outer portion 1006 oftissue thickness compensator 1000 such that slits 1010 may be positionedbetween the staples 1002 of row 1012 to allow for sufficient support forthe staples 1002 while maintaining an adequate flexibility within theouter portion 1006. Alternatively, under certain circumstances, slits1010 can be positioned within the staples 1002, for example, to provideflexibility within the staples 1002.

Referring now to FIG. 35, tissue thickness compensator 1000 may includea plurality of openings 1014 extending therethrough. As illustrated inFIG. 35, the openings 1014 may comprise generally cylindrical shapes.Alternatively, openings 1014 may comprise cone shapes which can benarrow on one side and wide on the other side of tissue thicknesscompensator 1000. Other geometrical shapes for openings 1014 arecontemplated within the scope of this disclosure. Tissue thicknesscompensator 1000 may also include multiple cavities 1016. As illustratedin FIG. 35, cavities 1016 may comprise generally cylindrical shapes,sometimes with tapered outer portions. Other geometrical shapes forcavities 1016 are contemplated within the scope of this disclosure. Forexample cavities 1016 can include closed ended cones. Openings 1014and/or cavities 1016 may provide regions of localized flexibility withintissue thickness compensator 1000 and can be positioned within the outerportion 1006, the inner portion 1004 and/or both portions 1004 and 1006to enhance the flexibility of the tissue thickness compensator 1000.Furthermore, as illustrated in FIG. 35, tissue thickness compensator1000 can include combinations of slits 1010, openings 1014, and/orcavities 1016 to yield a desired degree of flexibility.

Referring now to FIGS. 36-39, to improve its flexibility, the thicknessof the tissue thickness compensator 1000 can include patterns that mayprovide regions of localized flexibility. Such patterns can be embossedpatterns which can be molded or carved into the tissue thicknesscompensator 1000. As illustrated in FIG. 36, tissue thicknesscompensator 1000 can include a pattern 1020 comprising a plurality ofpyramids 1018 which can be arranged, for example, in rows. Pyramids1018, as illustrated in FIG. 37, can be separated from each by adistance “D.” The degree of flexibility of tissue thickness compensator1000 can, in part, be controlled by increasing or decreasing distance“D” between pyramids 1018. Pyramids 1018 can be arranged in otherpattern arrangements which are contemplated within the scope of thepresent disclosure. In addition, other geometrical shapes, cones forexample, and combinations thereof can also be used and are contemplatedwithin the scope of the present disclosure. As illustrated in FIG. 38,tissue thickness compensator 1000 may comprise a corrugated pattern1022. FIG. 38 shows a cross sectional view of corrugated pattern 1022 oftissue thickness compensator 1000 which may include multiple peaks 1024and multiple valleys 1026. The various patterns illustrated herein andcombinations thereof can be positioned within the outer portion 1006and/or the inner portion 1004 to enhance the flexibility of the tissuethickness compensator 1000.

Further to the above, referring to FIGS. 40 and 41, the outer edge 1008of tissue thickness compensator 1000 can comprise a generally atraumaticprofile which can minimize an impact upon tissue T, for example, duringand/or after the capturing of the tissue T and the tissue thicknesscompensator 1000 by staples 1002. For example, as illustrated in FIGS.40 and 41, outer edge 1008 can comprise a generally scalloped profile.Other atraumatic profiles such as a feathered profile, for example, forthe outer edge 1008 are also contemplated within the scope of thecurrent disclosure. In addition, tissue thickness compensator 1000 mayalso comprise an atraumatic nose portion 1028 and/or an atraumatic tailportion 1030. As illustrated in FIGS. 40 and 41, atraumatic nose portion1028 can comprise, for example, a generally curved shape and atraumatictail portion 1030 may, for example, comprise a split tail with flexibleends 1032. Other atraumatic shapes for the nose portion 1028 and/or thetail portion 1030 are also contemplated within the scope of the currentdisclosure.

Referring again to FIGS. 40 and 41, tissue thickness compensator 1000can comprise a gripping member 1034, which can reduce slippage betweenthe tissue thickness compensator 1000 and the cartridge deck 1064 whenthe tissue thickness compensator 1000 is placed against the cartridgedeck 1064. As illustrated in FIG. 40, gripping member 1034 can comprisemultiple cylindrically shaped protrusions 1036, for example, which canbe joined with corresponding recesses in the cartridge deck 1064.Gripping member 1034, as illustrated in FIG. 41, can comprise an arrowhead shaped protrusion 1038 which can be matted with a correspondingrecess in the cartridge deck 1064. Other gripping means for grippingtissue thickness compensator 1000 to cartridge deck 1064 arecontemplated within the scope of the present disclosure. Gripping member1034, as illustrated in FIGS. 40 and 41, can be positioned in the noseportion 1028. Alternatively, gripping member 1034 can be positioned inother portions of tissue thickness compensator 1000 such as, forexample, tail portion 1030.

Referring now to FIGS. 42-44, outer portion 1006 of tissue thicknesscompensator 1000 can comprise a cushioning member 1043 which can providea pliable edge that contacts tissue T, for example, during and/or afterthe capturing of the tissue T and the tissue thickness compensator 1000by staples 1002. In at least one embodiment, as illustrated in FIG. 44,cushioning member 1043 may comprise sufficient structural elasticity tocollapse and/or bend when compressed against the tissue T. Asillustrated in FIG. 43, cushioning member 1043 can partially extend overthe outer edge 1008 and may be attached to outer edge 1008 by anadhesive, for example. Other attachment means for attaching cushioningmember 1043 to outer edge 1008 are contemplated within the scope of thecurrent disclosure. Alternatively, cushioning member 1043 can be anintegral part of tissue thickness compensator 1000 that may bemanufactured therewith. Cushioning member 1043 may comprise abiocompatible foam which can be comprised of a biodegradable materialsuch as, for example, PGA, PCL, PLLA, and/or combinations thereof, forexample. Furthermore, cushioning member 1043 may be comprised, at leastin part, of alginate and/or oxidized regenerated cellulose (ORC). Forexample, cushioning member 1043 may include a plurality of alginateand/or ORC beads which may soften upon implantation in a patient whichmay increase the softness of cushioning member 1043.

The outer edge 1008 of the compensator 1000 may comprise a thicknessgreater than the thickness of the outer portion 1006. The greaterthickness of the outer edge 1008 may provide an atraumatic surface thatcontacts tissue T. Referring to FIGS. 45 and 46, outer portion 1006 oftissue thickness compensator 1000 can comprise a rolled outer edge 1046which can be at least partially extended around outer portion 1006 andinwardly rolled towards the inner portion 1004. Similar to the above,rolled outer edge 1046 can provide a pliable outer edge that contactstissue T, for example, during and/or after the capturing of the tissue Tand the tissue thickness compensator 1000 by staples 1002.

Referring to FIGS. 47-49, as described above, the staple cartridgechannel 1050 can be configured to receive a staple cartridge 1060 whichcan comprise a cartridge body 1062, a cartridge deck 1064. In addition,a tissue thickness compensator such as, for example, tissue thicknesscompensator 1100 may be removably positioned against or adjacentcartridge deck 1064, as illustrated in FIG. 47.

Referring again to FIGS. 47-49, a tissue thickness compensator may beconfigured to be absorbed after implantation in a patient. Theabsorption process may initially reduce the tissue thickness compensatorinto smaller pieces which may include rough edges that may haveundesirable effects on surrounding tissue T. To mitigate these effects,tissue thickness compensator 1100 may be at least partially assembledfrom a plurality of pieces 1140, which each may have atraumatic outerperipheries and may be joined together to form a single structure, asillustrated in FIG. 48. Pieces 1140 can be joined to form tissuethickness compensator 1100 in a manner such that the absorption processmay first reduce tissue thickness compensator 1100 into pieces 1140thereby minimizing the presence of rough edges. For example, pieces 1140may comprise circular profiles and may be joined together by thermalbonding to form tissue thickness compensator 1100. Other profiles andother means for joining pieces 1140 are contemplated within the scope ofthe present disclosure. In one example, pieces 1140 can be joinedtogether by an adhesive 1143 (See FIG. 48) configured to be absorbedfaster than pieces 1140 to allow separation of the pieces 1140 in aninitial stage of the absorption process. As illustrated in FIG. 48,pieces 1140 can be arranged in an overlapping array wherein an endportion of one of the pieces 1140 may overlap with an end portion ofanother one of the pieces 1140 such that the two end portions of thepieces 1140 are releasably attached to each other, for example, by anadhesive. Under certain circumstances, pieces 1140 can be arranged inanother overlapping array wherein one of the pieces 1140 can bepositioned over and releasably attached to a plurality of pieces 1140,as illustrated in FIG. 49.

Referring to FIGS. 50-53, as described above, a tissue thicknesscompensator may be configured to be absorbed after implantation in apatient and the absorption process may initially reduce the tissuethickness compensator into random smaller pieces. Guiding the absorptionprocess to yield small pieces with atraumatic outer edges can beachieved, as described above, by starting with small pieces havingatraumatic outer edges. Another approach may include modifying thetissue thickness compensator in such a manner that allows its separationinto smaller pieces having atraumatic peripheries in an initial stage ofthe absorption process. For example, as illustrated in FIG. 50, a tissuethickness compensator 1200 may comprise a pattern such as pattern 1212,for example, which can be molded or carved into the tissue thicknesscompensator 1200 to yield, for example, a plurality of circular shapedportions 1210. The portions 1210 may be defined by reducing thethickness of tissue thickness compensator 1200 along circumferences 1214of the circular shaped portions 1210, as illustrated in thecross-sectional view in FIG. 51. In result, a faster absorption alongthe circumferences 1214 of circular shaped portions 1210 may occur whichmay lead to a separation of the circular shaped portions 1210 from eachother in an initial stage of the absorption process. Patterns comprisingportions with other geometrical shapes with atraumatic outer peripheriesare contemplated within the scope of the current disclosure. Forexample, as illustrated in FIG. 52, tissue thickness compensator 1200′may comprise a pattern 1216 comprising portions 1218 which may includeprofiles that extend longitudinally in a wave-like profile along alength of tissue thickness compensator 1200′. In another example, asillustrated in FIG. 53, tissue thickness compensator 1200″ may comprisea pattern 1220 which may include hexagonal shaped portions 1222.

Referring to FIG. 54, as described above, a tissue thicknesscompensator, such as tissue thickness compensator 1250, may be capturedalong with tissue T by staples, such as staples 1002, for example, andmay be configured to be reduced into atraumatic pieces, such as pieces1226, for example, in an initial stage of the absorption process afterimplantation in a patient. Upon separation, pieces 1226 can move and/orslide relative to each other which may impact surrounding tissue T. Tominimize relative motion between pieces 1226, fired staples 1002 can bespatially arranged onto tissue thickness compensator 1250 such that astaple 1002 may capture multiple pieces 1226, as illustrated in FIG. 54.This may also aid in maintaining tissue thickness compensator 1250 in asubstantially singular structure even after pieces 1226 are separatedfrom each other in the initial stage of the absorption process. As such,the tissue thickness compensator 1250 may continue to provide supportfor tissue T captured by staples 1002 after pieces 1226 are separatedfrom each other in the initial stage of the absorption process.

Further to the above, referring now to FIG. 55, yet another approach canbe taken to guide the absorption process of a tissue thicknesscompensator to yield small pieces with atraumatic outer edges. Forexample, as illustrated in FIG. 55, a tissue thickness compensator suchas tissue thickness compensator 1300 may comprise a plurality of slits1310 which can be strategically positioned to improve the flexibility oftissue thickness compensator 1300, as described above. In addition,slits 1310 may partially divide tissue thickness compensator 1300 into aplurality of portions 1312 which may separate from each other during aninitial stage of the absorption process. Slits 1312 can reduce the widthof tissue thickness compensator 1300 along outer peripheries 1314 ofportions 1312, as illustrated in FIG. 55. This reduction in width maylead to faster absorption along the outer peripheries 1314 of portions1312, which can result in reducing tissue thickness compensator 1300into separate portions 1312 during the initial stage of the absorptionprocess.

Referring generally to FIGS. 55A-57, as described above, the staplecartridge channel 1050 can be configured to receive a staple cartridge1060, for example, which in at least one embodiment, can be removablyretained within the staple cartridge channel 1050. In variousembodiments, the staple cartridge 1060 can comprise a cartridge body1062, a cartridge deck 1064, and a tissue thickness compensator 1400wherein, in at least one embodiment, as illustrated in FIG. 55A, tissuethickness compensator 1400 may be removably positioned against oradjacent cartridge deck 1064 and may comprise protrusions (not shown),as described above for mating engagement with recesses 1402.

Referring again to FIGS. 55A-57, compensator 1400 may comprise aplurality of layers. For instance, compensator 1400 may comprise a firstlayer 1400A, and a second layer 1400B, which can be positioned over thefirst layer 1400A. In addition, an outer periphery 1418 of the secondlayer 1400B may be at least partially extended beyond an outer periphery1420 of the first layer 1400A. Furthermore, the first layer 1400A andthe second layer 1400B may comprise different degrees of stiffness. Forexample, the second layer 1400B may be configured to be more flexiblethan the first layer 1400A. As illustrated in FIG. 55B, this arrangementmay provide tissue thickness compensator 1400 with a sufficiently rigidinner region, comprised from the first layer 1400A and the second layer1400 B, which may be suitable to provide adequate support for staples1002, and a sufficiently flexible outer region, comprised from thesecond layer 1400B, which may be suitable to provide sufficientflexibility to soften the impact upon tissue T, for example, duringand/or after the capturing of the tissue T and the tissue thicknesscompensator 1400 by staples 1002. Layers 1400A and 1400B can be joinedtogether, for example, by an adhesive. Other attachment means forattaching the first layer 1400A to the second layer 1400B arecontemplated within the scope of the current disclosure.

Further to the above, referring again to FIG. 55A, the first layer 1400Amay include an inner portion 1404 and an outer portion 1406 at leastpartially surrounding the inner portion 1404, wherein the outer portion1406 may be configured to be more flexible than the inner portion 1404.For example, as illustrated in FIG. 55A, the outer portion 1404 maycomprise a plurality of slits 1410, which as described above, mayincrease the flexibility of the outer portion 1404. Furthermore, asdescribed above, the second layer 1400B may be configured to be moreflexible than the first layer 1400A. This arrangement may provide tissuethickness compensator 1400 with three regions of different rigidityincluding a first inner region having the most rigidity, the innerregion being comprised of inner portion 1404 of first layer 1400A andsecond layer 1400B, a middle region having an intermediate rigidity, themiddle region being comprised of outer portion 1408 of first layer 1400Aand the second layer 1400B, and a third outer region having the leastrigidity, the third region being comprised solely of the second layer1400B.

Referring now to FIGS. 56 and 57, the second layer 1400B of tissuethickness compensator 1400 can comprise a woven structure 1440, whichmay include a plurality of fibers 1442 which may be woven into wovenstructure 1440. The woven structure 1440 may provide the second layer1400B with sufficient flexibility to soften the impact upon tissue T,for example, during and/or after the capturing of the tissue T and thetissue thickness compensator 1400 by staples 1002. Furthermore, theouter periphery 1418 can be comprised of fibers 1042 which can providean atraumatic tissue contacting surface to minimize impact upon tissueT, as described above. Woven structure 1440 and fibers 1042 can becomprised of biocompatible materials. Furthermore, woven structure 1040and/or fibers 1042 can be comprised from a bioabsorbable material suchas PLLA, PGA, PCL, and/or combinations thereof, for example.

Referring now to FIGS. 60-60B, as described in greater detail below, atissue thickness compensator 11050 can comprise a proximal end 11053 anda distal end 11055 wherein the proximal end 11053 and/or the distal end11055 can comprise one or more strain relief portions which can reducethe rigidity of the tissue thickness compensator 11050 and the rigidityof the tissue being stapled. The distal end 11055 of the tissuethickness compensator 11050 can comprise one or more slots 11058 definedtherein. The slots 11058 can comprise cuts and/or notches, for example,defined in the tissue thickness compensator 11050. The slots 11058 candefine projections, or tabs, 11056 which can be configured to at leastpartially move and/or flex relative to one another and/or the bodyportion of the tissue thickness compensator 11050. Stated another way,the slots 11058 can provide localized strain relief to the tissuethickness compensator 11050 and the underlying tissue. In certaincircumstances, the tabs 11056 of a first tissue thickness compensator11050 can be overlapped with a proximal end 11053 of a second tissuethickness compensator 11050. In various circumstances, the slots 11058can permit the first tissue thickness compensator 11050 and the secondtissue thickness compensator to pivot relative to one another. Incertain circumstances, referring primarily to FIG. 60B, the tabs 11056of a first tissue thickness compensator 11050 can be overlapped with thetabs 11056 of a second tissue thickness compensator 11050. In variouscircumstances, the slots 11058 in the overlapped distal ends 11055 canfurther reduce the rigidity within the underlying tissue. Although theillustrated embodiment of tissue thickness compensator 11050 onlycomprises an arrangement of tabs 11057 and slots 11058 on one endthereof, a tissue thickness compensator may comprise an arrangement oftabs 11056 and slots 11058 on both ends thereof, for example.

In certain embodiments, further to the above, each tab 11056 cancomprise a tapered profile. For instance, each tab 11056 can comprise abase attached to the body of the tissue thickness compensator 11050having a base width and a free end on the opposite end thereof having anend width, wherein the base width can be wider than the end width. Incertain embodiments, the end width can be wider than the base width.Referring primarily to FIG. 60B, an end 11055 can comprise a pluralityof tabs 11056 having different configurations. For instance, the tabs11056 can have different lengths. As illustrated in FIG. 60B, anend-most tab 11056 a can have a first length, a second tab 11056 b canhave a second length which is longer than the first length, a third tab11056 c can have a third length which is longer than the second length,a fourth tab 11056 d can have a fourth length which is longer than thethird length, a fifth tab 11056 e can have a fifth length which islonger than the fourth length, and a sixth tab 11056 f can have a sixthlength which is longer than the fifth length, for example. In such anembodiment, the tabs 11056 can become progressively shorter toward thedistal end of the tissue thickness compensator 11050. In otherembodiments, the lengths of the tabs 11056 can be arranged in any othersuitable arrangement.

In various circumstances, further to the above, a layer can compriseedges which define the perimeter of the layer. These edges may bestraight, substantially straight, linear, and/or substantially linear,in certain circumstances. In some such circumstances, the layer edgesmay impinge on and/or otherwise affect the surrounding tissue. Also, insome such circumstances, the edges may be rigid and may rigidly supportthe tissue. In effect, certain portions of the tissue may be unsupportedby the layer which are adjacent to other portions of the tissue whichare rigidly supported by the layer without transition therebetween.Referring to FIGS. 60-60B once again, the perimeter of the tissuethickness compensator 11050 can include a contoured configuration whichcan provide a region of transitional rigidity to the underlying tissue.The perimeter of the tissue thickness compensator 11050 can comprise aplurality of notches or recesses 11059 defined therein which can definetabs 11057. Similar to the above, the tabs 11057 can extend from thebody of the tissue thickness compensator 11050 and can move relativethereto. Also similar to the above, each tab 11057 can comprise a baseend attached to the body of the tissue thickness compensator 11050 andfree end which is movable relative to the base end. In certaincircumstances, the free end of a tab 11057 can have a width which isnarrower than the width of the base end of the tab 11057 while, in othercircumstances, the free end of a tab 11057 can have a width which iswider than the width of the base end of the tab 11057. The tabs 11057can comprise any suitable configuration such as a semi-circular, or anat least partially arcuate, configuration, for example. As a result ofthe above, the tissue underlying and/or fastened to the body portion ofthe tissue thickness compensator 11050 can be rigidly supported by thebody portion, the tissue underlying and/or fastened to the tabs 11057can be less than rigidly supported by the tabs 11057, and the tissueadjacent to the tabs 11057, but not underlying the tabs 11057, may beunsupported by the tissue thickness compensator 11050.

Referring now to FIGS. 58 and 59, a staple cartridge assembly 11100 cancomprise a cartridge body 11110 and a tissue thickness compensator 11150attached to the cartridge body 11110. The cartridge assembly 11100 canfurther comprise one or more attachment members 11160 configured toreleasably hold the tissue thickness compensator 11150 to the cartridgebody 11110. In at least one circumstance, each attachment member cancomprise a strap which extends around the cartridge body 11110 and thetissue thickness compensator 11150. In use, further to the above, afiring member 10030 can be advanced through the staple cartridge 11100to incise the tissue thickness compensator 11150, fire the staples atleast partially stored in the cartridge body 11110, and sever theattachment members 11160. The tissue thickness compensator 11150 cancomprise a first, or proximal, end 11157 and a second, or distal, end11155. The distal end 11155 can comprise an elongate projection 11156extending from a body portion 11153 of the tissue thickness compensator11150. As illustrated in FIG. 58, the elongate projection 11156 canextend distally with respect to the distal-most attachment member 11160.In at least the illustrated embodiment, the cartridge body 11110 cancomprise a deck 11113 within which staple cavities of the cartridge body11110 can be defined. In various circumstances, the body 11153 of thetissue thickness compensator 11150 can be configured and arranged suchthat it covers the deck 11113 and the staple cavities defined in thecartridge body 11110. In at least some circumstances, as alsoillustrated in FIG. 58, the elongate projection 11156 can extenddistally from the deck 11113 and extend distally with respect to thestaple cavities defined in the deck 11113.

In use, further to the above, the tissue thickness compensator 11150 canbe fastened to tissue and can provide tissue thickness compensationproperties, as described herein. Similar to the above, the tissueunderlying the tissue thickness compensator 11150 may be rigidlysupported by the tissue thickness compensator 11150 and the staplessecuring the same whereas the tissue surrounding the tissue thicknesscompensator 11150 may be unsupported by the tissue thickness compensator11150 and may be flexible. In such circumstances, the tissue between theflexible unsupported tissue and the rigidly supported tissue underlyingthe tissue thickness compensator 11150, i.e., the transition tissue, canundergo an undesirable amount of strain. Such strain may negativelyimpact the transition tissue. For instance, when a tissue thicknesscompensator is secured to pulmonary, or lung, tissue, for example, thetissue immediately surrounding the perimeter of the tissue thicknesscompensator, i.e., the perimeter tissue, may tear in certaincircumstances, especially the perimeter tissue adjacent to and/orsurrounding the distal end of the tissue thickness compensator, i.e.,the end perimeter tissue. The distal projection 11156 of the tissuethickness compensator 11150, however, can support the end perimetertissue. Stated another way, the distal projection 11156 can providetransitional support to the end perimeter tissue. Such transitionalsupport can be less than the support provided by the body of the tissuethickness compensator 11150 and can mitigate the change in strainbetween the unsupported tissue and the fully supported tissue underlyingthe tissue thickness compensator 11150. In various circumstances, thedistal projection 11156 can provide an enlarged area in which force canbe transmitted between the unstapled tissue and the stapled tissue. Thedistal projection 11156 can be configured to flex and move with theunsupported tissue and the tissue thickness compensator 11150. Invarious circumstances, the distal projection 11156 can move relative tothe body portion of the tissue thickness compensator 11150 and/or theunsupported tissue.

The tissue thickness compensator 11150, referring again to FIGS. 58 and59, can further comprise a notch 11157 defined in the proximal end 11153thereof. The notch 11157 can be defined between two distally extendingprojections 11158. The notch 11157 can comprise any suitable shape, suchas a parabolic shape, for example. Similar to the above, the distallyextending projections 11158 can provide transitional support to theproximal end perimeter tissue. Such transitional support can be lessthan the support provided by the body of the tissue thicknesscompensator 11150 and can mitigate the change in strain between theunsupported tissue and the fully supported tissue underlying the tissuethickness compensator 11150. In various circumstances, the proximalprojections 11158 can provide an enlarged area in which force can betransmitted between the unstapled tissue and the stapled tissue. Theproximal projections 11158 can be configured to flex and move with theunsupported tissue and the tissue thickness compensator 11150. Invarious circumstances, the proximal projections 11158 can move relativeto the body portion of the tissue thickness compensator 11150, eachother, and/or the unsupported tissue. Various alternative embodimentsare envisioned in which more than two projections extend from theproximal end and/or distal end of a tissue thickness compensator.

As illustrated in FIG. 59, two or more tissue thickness compensators11150 can be implanted in an end-to-end manner along a path. In suchcircumstances, the distal end 11155 of a first tissue thicknesscompensator 11150 can overlap with the proximal end 11153 of a secondtissue thickness compensator 11150. Similarly the distal end 11155 ofthe second tissue thickness compensator 11150 can overlap with theproximal end 11153 of a third tissue thickness compensator 11150. Invarious circumstances, the distal projection 11156 of the first tissuethickness compensator 11150 can be aligned, or at least substantiallyaligned, with the recess 11157 of the second tissue thicknesscompensator 11150. Also, in various embodiments, the distal projection11156 and the proximal recess 11558 can be sized and configured suchthat they have substantially the same size and/or shape. In variouscircumstances, a distal projection 11156 can be configured to bepositioned within a proximal recess 11157 of an adjacent tissuethickness compensator 11150.

In various embodiments, referring now to FIG. 61, a staple cartridgeassembly 16000 can comprise a cartridge body 16010 and a layer assembly16020. The cartridge body 16010 can comprise a deck 16011 and alongitudinal slot 16012 defined in the deck 16011 which can beconfigured to slidably receive a cutting member 16030 therein. Thecartridge body 16010 can further comprise a plurality of staple cavitiesdefined therein which can each be configured to removably store a stapletherein. The staple cavities can be part of two or more groups. Forinstance, the staple cavities can be divided into a first group ofstaple cavities 16015 and a second group of staple cavities 16016. Invarious circumstances, the groups of staple cavities can be organized inrows while, in other circumstances, the groups of staple cavities canoverlap, or be inter-dispersed, with each other. In either event, thelayer assembly 16020 can comprise a plurality of layers which can extendover the staple cavities. In use, as described in greater detail furtherbelow, the staples, when ejected from the staple cavities, can captureat least a portion of the layer assembly 16020 therein. The layers ofthe layer assembly 16020 can be configured such that only certain layersof the layer assembly 16020 extend over certain staple cavities. Forinstance, the layer assembly 16020 can comprise a first layer 16050which can extend over the first group of staple cavities 16015 and thesecond group of staple cavities 16016 and, in addition, a second layer16040 which can extend over the second group of staple cavities 16016but may not extend over the first group of staple cavities 16015.

In use, as a result the above and referring primarily to FIG. 62,certain staples deployed from the staple cartridge 16000 may captureonly the first layer 16050 of the layer assembly 16020 while otherstaples may capture only the second layer 16040 of the layer assembly16020. For instance, one or more outer rows of staples 16061 may captureonly the first layer 16050 while one or more inner rows of staples 16063may capture both the first layer 16050 and the second layer 16040. Invarious embodiments, one or more intermediate rows of staples 16062 caninclude some staples which capture only the first layer 16050 and otherstaples which capture both the first layer 16050 and the second layer16040. In at least one embodiment, the second layer 16040 can comprise aplurality of tabs 16043 which can be configured to be captured withinthe staples 16062 of the intermediate row. The tabs 16043 can beseparated by slots 16044 which can permit the tabs 16043 to move andflex relative to one another. For instance, the arrangement of slots16044 and tabs 16043 can introduce flexibility within the staple tissue.In certain embodiments, the tabs 16043 can be sufficiently spaced apartsuch that some of the intermediate staples 16062 may capture a tab 16043therein while others may not. Referring primarily to FIG. 61 once again,the second layer 16040 can include a longitudinal projection 16042extending therefrom which can be configured to extend into thelongitudinal slot 16012 defined in the cartridge body 16010. In variouscircumstances, the longitudinal projection 16042 can be releasablysecured or within the longitudinal slot 16012. In at least oneembodiment, the longitudinal projection 16042 can fit snugly within thelongitudinal slot 16012 via a press-fit engagement, for example. In anyevent, the engagement between the longitudinal slot 16012 and thelongitudinal projection 16042 can maintain the alignment between thesecond layer 16040 and the cartridge body 16010. Moreover, the firstlayer 16050 can be mounted to the second layer 16040 such that theprojection 16042 can also hold the first layer 16050 in position.

Further to the above, the first layer 16050 of the layer assembly 16020can cover a first group of staple cavities and the second layer 16040can cover a second group of staple cavities. Stated another way, thefirst layer 16050 of the layer assembly 16020 can have a differentfootprint than the second layer 16040. In various embodiments, the firstlayer 16050 of the layer assembly 16020 and the second layer 16040 canbe comprised of different materials. In at least one such embodiment,the second layer 16040 can comprise a rigid material and can beconfigured to support the first layer 16050. The first layer 16050 canbe comprised of a flexible material, or at least a material which ismore flexible than the material comprising the second layer 16050.Referring primarily to FIG. 62, the flexible first layer 16050 canextend laterally beyond the second layer 16040. In such circumstances,the first layer 16050 can provide for a more flexible lateral edge ofthe layer assembly 16020. After the layer assembly 16020 has beenimplanted against the tissue T by the staples and transected by thecutting member 16030, referring primarily to FIG. 62, the second layer16050 can support the tissue T located adjacent to the transection linewhile the first layer 16040 can extend laterally away alongside thetissue T. In various circumstances, the first layer 16040 can provide aflexible transition between the tissue T supported by the second layer16050 and the tissue T unsupported by the layer assembly 16020. Invarious circumstances, the first layer 16050 can comprise a tissuethickness compensator and the second layer 16040 can be comprised of alaminate material, for example.

In various embodiments, referring primarily to FIG. 61, the layerassembly 16020 can be attached to the cartridge body 16010. In at leastone embodiment, the cartridge assembly 16000 can comprise at least onetie, or connector, which can releasably hold the layer assembly 16020 tothe cartridge body 16010. For instance, the cartridge assembly 16000 cancomprise a first connector releasably holding a distal end 16021 of thelayer assembly 16020 to a distal end of the cartridge body 16010 and asecond connector holding a proximal end 16022 of the layer assembly16020 to a proximal end of the cartridge body 16010. As the firingmember 16030 is advanced from the proximal end to the distal end of thecartridge body 16010 to deploy the staples therefrom and incise thelayer assembly 16020, the firing member 16030 can also transect and/orotherwise defeat the connectors holding the layer assembly 16020 to thecartridge body 16010.

Referring now to FIGS. 64-66, an end effector assembly 5400 can includea first jaw, illustrated elsewhere, and a second jaw 5402. In variousembodiments, the second jaw 5402 can include a fastener cartridge body5450 and a layer of material 5458 releasably secured to the fastenercartridge body 5450 and/or to the second jaw 5402. The fastenercartridge body 5450 and the layer of material 5458 releasably securedthereto can comprise a fastener cartridge assembly, for example. Invarious embodiments, the layer of material 5458 can comprise a piece ofbuttress material and/or a tissue thickness compensator, for example. Incertain embodiments, the layer of material 5458 can be a piece ofbuttress material releasably secured to the fastener cartridge body5450, for example. The second jaw 5402 can have a proximal portion 5404and a distal portion 5406. In various embodiments, the second jaw 5402can have a proximal connector 5480 a (FIGS. 65 and 66) at the proximalportion 5404 and a distal connector 5480 b (FIG. 66) at the distalportion 5406. The proximal connector 5480 a and the distal connector5480 b can secure the layer of material 5458 relative to the cartridgebody 5450. The connectors 5480 a, 5480 b can comprise bands and/orcords, for example.

Referring primarily to FIG. 64, the cartridge body 5450 can include adeck 5452. A slot 5456 can extend from the proximal portion 5404 towardthe distal portion 5406 of the second jaw 5402, for example, and can bedefined in a portion of the deck 5452, for example. In variousembodiments, fastener cavities 5454 can also be defined in the deck5452. Further, the second jaw 5402 can include fasteners, such assurgical staplers, for example, removably positioned in the fastenercavities 5454. For example, a fastener can be ejectably positioned ineach fastener cavity 5454 of the cartridge body 5450. In variousembodiments, the fasteners can be ejected from their respective fastenercavities 5454 by a sled 5434 (FIGS. 65 and 66) during a firing stroke.

Referring primarily to FIGS. 65 and 66, a firing assembly 5430 caninclude a firing bar 5432, a cutting edge 5436, and a foot 5438. Thecutting edge 5438 can cut tissue and/or the layer of material 5458, forexample, and the foot 5438 can guide the firing assembly 5430 along theslot 5456 in the cartridge body 5450 (FIG. 64), for example. In variousembodiments, the firing assembly 5430 can move along the slot 5456 inthe cartridge body 5450 during a firing stroke. The firing assembly 5430can engage the sled 5434 in the cartridge body 5430 and can drive thesled 5434 at least partially through the cartridge body 5450, forexample. In certain embodiments, the sled 5434 can have a cammingsurface or ramp 5442, which can engage drivers in the fasteners cavities5454 during the firing stroke. When the ramp 5442 engages a driver in afastener cavity 5454, the ramp 5442 can cam the driver and thecorresponding fastener toward the cartridge deck 5452, and can eject thefastener from the fastener cavity 5454, for example. In certainembodiments, referring primarily to FIG. 65, at the beginning of thefiring stroke, the firing assembly 5430 can be positioned at a proximalportion 5404 of the second jaw 5402. In such embodiments, referringprimarily to FIG. 66, the firing bar 5432 can drive the firing assembly5430 distally during the firing stroke. In various embodiments, thecutting edge 5436 can cut the proximal connector 5480 a and the distalconnector 5480 b during the firing stroke. The cutting edge 5436 can cutthe proximal connector 5480 a at or near the beginning of the firingstroke, for example, and can cut the distal connector 5480 b at or nearthe end of the firing stroke, for example.

Referring still to FIGS. 64-66, the layer of material 5458 can besecured to the deck 5452 of the cartridge body 5450 (FIG. 64) by theproximal connector 5480 a (FIG. 65) and by the distal connector 5480 b(FIGS. 65 and 66). Furthermore, the layer of material 5458 can includeat least one mount 5460. The mount 5460 can be integrally molded withthe layer of material 5458, for example. In certain embodiments, whenthe layer of material 5458 is secured to the deck 5452, the mount 5460can extend from the layer of material 5458 into the slot 5456 of thecartridge body 5450. Referring primarily to FIG. 65, the mount 5460 canextend into the slot 5456 (FIG. 64) between the proximal connector 5480a and the distal connector 5480 b, for example. In other words, themount 5460 can extend from an intermediate portion 5468 of the layer ofmaterial 5458. In various embodiments, the mount 5460 can be sized tofit in the slot 5456 when the layer of material 5458 is positioned onthe deck 5452 cartridge body 5450. Furthermore, the mount 5460 can besized for unforced removal from the slot 5456 when the layer of material5458 is lifted and/or peeled away from the cartridge body 5458. Forexample, the mount 5460 may not be friction fit in the slot 5456 and, incertain embodiments, when the mount 5460 is positioned in the slot 5456,a clearance or gap can exist between the mount 5460 and the slot 5456.The clearance can be approximately 0.12 mm, for example. In certainembodiments, the clearance can be up to approximately 0.24 mm, forexample. In some embodiments, an interference of approximately 0.01 mmto approximately 0.12 mm can exist between the mount 5460 and the slot5456, for example, such that the mount 5460 is compressed whenpositioned in the slot 5456, for example.

Referring still to FIGS. 64-66, the mount-slot engagement can preventand/or limit lateral shifting and/or buckling of the intermediateportion 5468 of the layer of material 5458. For example, when the endeffector assembly 5400 is placed and/or moved relative to tissue at asurgical site, the mount 5460 can remain positioned within the slot 5456(FIG. 64) to hold the intermediate portion 5468 in position relative tothe cartridge deck 5452. Some shifting of the layer of material 5458 maybe possible owing to the clearance defined between the mount 5460 andthe slot 5456, for example. In various embodiments, the mount 5460 maynot resist lifting and/or peeling of the layer of material 5458 awayfrom the cartridge body 5450. For example, the mount 5460 may not befriction fit in the slot 5456, and the mount 5460 can be easily removedfrom the slot 5456 when the layer of material 5458 is lifted away fromthe deck 5452 of the cartridge body 5450, for example, after the cuttingedge 5436 cuts the proximal connector 5680 a and the distal connector5680 b. For example, as the firing assembly 5430 is driven distallyduring the firing stroke, an element of the firing assembly 5430 cancontact the mount 5460 within the slot 5456. Referring primarily to FIG.66, the sled 5434 can contact the mount 5460 when the sled 5434 isdriven distally by the firing assembly 5430. Further, the sled 5434 canflex the mount 5460 out of the sled's path and out of the slot 5456. Inother words, the sled 5434 can flex the mount 5460 to remove the mount5460 from the slot 5456.

In various embodiments, the layer of material 5458 can include multiplemounts 5460, which can extend from the layer of material 5458 into theslot 5456 (FIG. 64) in the cartridge body 5450. The mounts 5460 can bespaced along at least a portion of the length of the slot 5456, forexample. In certain embodiments, at least one mount 5460 can bepositioned in the proximal portion 5404 of the second jaw 5402, and atleast one mount 5460 can be positioned in the distal portion 5406 of thesecond jaw 5402. Further, the mounts 5460 can be positioned intermediatethe proximal and distal connectors 5480 a, 5480 b (FIG. 65), forexample. As the firing assembly 5430 (FIGS. 65 and 66) is fired distallyduring the firing stroke, the sled 5434 can sequentially engage eachmount 5460 in the slot 5456 to flex and remove each mount 5460 from theslot 5456. When each mount 5460 is released from the slot 5456 and theproximal and distal connectors 5480 a, 5480 b are cut or otherwiseovercome, the layer of material 5458 can be unsecured relative to thedeck 5452 of the cartridge body 5450.

Referring still to FIGS. 64-66, a mount 5460 can include a flexible stem5462 and a head 5464. The flexible stem 5462 of the mount 5460 can flexwhen an element of the firing assembly 5430, such as the sled 5434,pushes against the head 5464 during the firing stroke. In certainembodiments, the head 5464 can have an enlarged, rounded shape tominimize the clearance between the head 5464 and the slot 5456 of thecartridge body 5450. In various embodiments, the head 5464 can fitwithin the slot 5456, and can be easily and smoothly removed from theslot 5456 when the layer of material 5458 lifted and/or peeled away fromthe cartridge body 5450.

Referring now to FIGS. 67-70, an end effector assembly 5500 can includea first jaw, illustrated elsewhere, and a second jaw 5502. In variousembodiments, the second jaw 5502 can include the cartridge body 5450 anda layer of material 5558 releasably secured to the cartridge body 5450and/or to the second jaw. The cartridge body 5450 and the layer ofmaterial 5558 releasably secured thereto can comprise a fastenercartridge assembly, for example. In various embodiments, the layer ofmaterial 5558 can comprise a piece of buttress material and/or a tissuethickness compensator, for example. In certain embodiments, the layer ofmaterial 5558 can be a piece of buttress material releasably secured tothe cartridge body 5450. Further, the second jaw 5502 can have aproximal portion 5504 and a distal portion 5506. In various embodiments,the second jaw 5502 can have a proximal connector 5580 a (FIGS. 68 and69) at the proximal portion 5504 and a distal connector 5580 b (FIG. 68)at the distal portion 5506. The proximal connector 5580 a and the distalconnector 5580 b can secure the layer of material 5558 relative to thecartridge body 5450. In various embodiments, the layer of material 5558can include a ridge 5560. The ridge 5560 can be integrally molded withthe layer of material 5558, for example. Referring primarily to FIG. 67,the ridge 5560 can extend longitudinally along at least a portion of thelength of the layer of material 5558.

Referring primarily to FIG. 69, when the layer of material 5558 issecured to the cartridge body 5460, the ridge 5560 can extend into theslot 5456 in the cartridge body 5450. The ridge 5560 can extend into theslot 5456 between the proximal connector 5580 a and the distal connector5580 b, for example. In various embodiments, the ridge 5560 can be sizedto fit in the slot 5456 when the layer of material 5558 is positioned onthe cartridge body 5450. Furthermore, the ridge 5560 can be sized forunforced removal from the slot 5456 when the layer of material 5558 islifted and/or peeled away from the cartridge body 5458. For example, theridge 5560 may not be friction fit in the slot 5456 and, in certainembodiments, when the ridge 5560 is positioned with the slot 5456, aclearance or gap can exist between the ridge 5560 and the slot 5456. Theclearance can be approximately 0.08 mm, for example. In certainembodiments, the clearance can be up to approximately 0.24 mm, forexample. In some embodiments, an interference of approximately 0.01 mmto approximately 0.06 mm can exist between the ridge 5560 and the slot5456, for example, such that the ridge 5560 is compressed whenpositioned in the slot 5456, for example.

In various embodiments, the ridge-slot engagement can prevent and/orlimit lateral shifting and/or buckling of the layer of material 5558relative to the deck 5452 of the cartridge body 5450. For example, whenthe end effector assembly 5500 is placed and/or moved relative to tissueat a surgical site, the ridge 5560 can remained positioned in the slot5456 to hold the layer of material 5558 in position relative to thecartridge deck 5452. Some shifting of the layer of material 5558relative to the cartridge body 5450 may be possible owing to theclearance defined between the ridge 5560 and the slot 5456, for example.In various embodiments, the ridge 5560 may not resist lifting and/orpeeling of the layer of material 5558 away from the cartridge body 5450.For example, the ridge 5560 may not be friction fit in the slot 5456,and the ridge 5560 can be easily and smoothly removed from the slot 5456when the layer of material 5550 is lifted away from the deck 5452 of thecartridge body 5450, for example, after the cutting edge 5436 cuts theproximal connector 5680 a and the distal connector 5680 b. In variousembodiments, the cutting edge 5436 of the firing assembly 5430 can cutthe layer of material 5558, as well as the ridge 5560, for example, whenthe cutting edge 5436 is driven distally during the firing stroke.

Referring primarily to FIGS. 68-70, the layer of material 5558 caninclude a reinforcement feature 5570, which can extend along at least aportion of the length of the layer of material 5558. The reinforcementfeature 5570 can extend from a proximal portion 5504 of the second jaw5502 toward the distal portion 5506 of the second jaw 5502, for example.The reinforcement feature 5570 can be integrally molded with the layerof material 5558, for example. In various embodiments, the reinforcementfeature 5570 can increase the moment of inertia of the layer of material5558 such that the reinforcement feature 5570 can reinforce, supportand/or rigidify the layer of material 5558. For example, when thecutting edge 5436 (FIGS. 65 and 66) traverses the layer of material 5558during the firing stroke, the reinforcement feature 5570 can preventand/or limit shifting and/or buckling of the layer of material 5558relative to the cartridge body 5450. Further, the reinforcement feature5570 can engage tissue clamped between the first jaw and the second jaw5502 of the end effector assembly 5500. In certain embodiments, thereinforcement feature 5570 can prevent and/or limiting shifting of theclamped tissue relative to the cartridge body 5450, for example. Invarious embodiments, the layer of material 5558 can include multiplereinforcement features 5570, which can extend along at least a portionof the length of the layer of material 5558. The reinforcement features5570 can be parallel, for example, and can extend on either side or bothsides of the ridge 5560, for example. In various embodiments, thereinforcement feature 5570 and/or the ridge 5560 can extend along aportion of the length of the layer of material 5558 and can stop beforereaching the distal portion thereof. The absence of the reinforcementfeature 5570 and/or the ridge 5560 at the distal portion can lendflexibility to the distal portion of the layer of material 5558.

Referring now to FIG. 71, a layer of material 5588 for use with an endeffector assembly can have a longitudinal ridge 5590, similar to theridge 5560, for example. In various embodiments, the layer of material5588 and/or the ridge 5590 can be a piece of buttress material and/or atissue thickness compensator, for example. The ridge 5590 can extendalong at least a portion of the length of the layer of material 5588.Further, the ridge 5590 can be received within a slot in the endeffector, such as the slot 5456 in the cartridge body 5450 (FIG. 67),for example. In certain embodiments, the ridge 5590 can providesufficient reinforcement, support, and rigidity to the layer of material5588, without the addition of supplementary reinforcement features, forexample.

Referring now to FIGS. 72-75, an end effector assembly 5600 can includea first jaw, illustrated elsewhere, and a second jaw 5602. In variousembodiments, the second jaw 5602 can include the cartridge body 5450 anda layer of material 5658 releasably secured to the cartridge body 5450and/or to the second jaw 5602. In various embodiments, the cartridgebody 5450 and the layer of material 5458 releasably secured thereto cancomprise a fastener cartridge assembly, for example. The layer ofmaterial 5658 can comprise a piece of buttress material and/or a tissuethickness compensator, for example. In certain embodiments, the layer ofmaterial 5658 can be a piece of buttress material releasably secured tothe cartridge body 5450, for example. Further, the second jaw 5602 canhave a proximal portion 5604 and a distal portion 5606. In variousembodiments, the second jaw 5602 can have a proximal connector 5680 a(FIGS. 73 and 74) at the proximal portion 5604 and a distal connector5680 b (FIG. 73) at the distal portion 5606. The proximal connector 5680a and the distal connector 5680 b can secure the layer of material 5658relative to the cartridge body 5450. In various embodiments, the layerof material 5658 can include a ridge 5660. The ridge 5660 can beintegrally molded with the layer of material 5658, for example.Referring primarily to FIG. 72, the ridge 5660 can extend longitudinallyalong at least a portion of the length of the layer of material 5658. Invarious embodiments, the ridge 5660 can be a folded portion of the layerof material 5658. For example, the layer of material 5658 can becrimped, creased and/or folded over itself to form a thicker portion,which can be the ridge 5660. Referring primarily to FIGS. 74 and 75, theridge 5660 can be folded into a U-shape, for example, and can include arounded tip 5662.

Referring primarily to FIG. 74, when the layer of material 5658 issecured to the cartridge body 5460, the ridge 5660 can extend into theslot 5456 in the cartridge body 5450. In certain embodiments, the slot5456 can be structured to receive the ridge 5660. The ridge 5660 can besized to fit in the slot 5456 when the layer of material 5658 ispositioned on the cartridge body 5450. Furthermore, the ridge 5660 canbe sized for unforced removal from the slot 5456 when the layer ofmaterial 5658 is lifted and/or peeled away from the cartridge body 5458.For example, the ridge 5660 may not be friction fit in the slot 5456and, in certain embodiments, when the ridge 5660 is positioned withinthe slot 5456, a clearance or gap can exist between the ridge 5660 andthe slot 5456. The clearance can be approximately 0.12 mm, for example.In certain embodiments, the clearance can be up to approximately 0.24mm, for example. In some embodiments, an interference of approximately0.01 mm to approximately 0.18 mm can exist between the ridge 5660 andthe slot 5456, for example, such that the ridge 5660 is compressed whenpositioned in the slot 5456, for example.

In various embodiments, the ridge-slot engagement can prevent and/orlimit lateral shifting and/or buckling of the layer of material 5658.For example, when the end effector assembly 5600 is placed and/or movedrelative to tissue at a surgical site, the ridge 5660 can remainedpositioned in the slot 5456 to hold the layer of material 5658 inposition relative to the cartridge deck 5452. Shifting of the layer ofmaterial 5658 relative to the cartridge body 5450 can be limited by theclearance. For example, some sifting of the layer of material 5658 maybe possible owing to the clearance defined between the ridge 5660 andthe slot 5456. In various embodiments, the ridge 5660 may not resistlifting and/or peeling of the layer of material 5658 away from thecartridge body 5450. For example, the ridge 5660 may not be friction fitin the slot 5456, and the ridge 5660 can be easily removed from the slotwhen the layer of material 5658 is lifted away from the deck 5452 of thecartridge body 5450, for example, after the cutting edge 5436 cuts theproximal connector 5680 a and the distal connector 5680 b. In variousembodiments, when the firing assembly 5430 (FIGS. 65 and 66) is firedalong the slot 5456 during a firing stroke, the sled 5434 and/or anotherelement of the firing assembly 5430 can easily and smoothly release theridge 5660 from the slot 5456, for example, to release the layer ofmaterial 5658 from the cartridge body 5450. The cutting edge 5436 of thefiring assembly 5430 can cut the layer of material 5658, as well as theridge 5660, for example, when the cutting edge 5436 is driven distallyduring the firing stroke.

Referring primarily to FIGS. 73-75, the layer of material 5658 caninclude a reinforcement feature 5670, which can extend along at least aportion of the length of the layer of material 5658. The reinforcementfeature 5670 can extend from the proximal end of the second jaw 5602 tothe distal end of the second jaw 5602, for example. The reinforcementfeature 5670 can be integrally molded with the layer of material 5658,for example. In various embodiments, the reinforcement feature 5670 canbe a folded portion of the layer of material 5658. For example, thelayer of material 5658 can be creased, crimped and/or folded over itselfto form a thicker portion, which can form the reinforcement feature5670. Referring primarily to FIGS. 74 and 75, the reinforcement feature5670 can be crimped into a V-shape, and can include a pointed tip 5672,for example. In various embodiments, the reinforcement feature 5670 canreinforce, support and/or rigidify the layer of material 5658. In someembodiments, the reinforcement feature 5670 can be configured to bendalong the tip 5672 thereof to resist a lateral force applied along theedge of the layer of material 5658 such that the layer of material 5658remains positioned on the cartridge body 5450. For example, when thecutting edge 5436 (FIGS. 65 and 66) traverses the layer of material 5658during the firing stroke, the reinforcement feature 5670 can preventand/or limit shifting and/or buckling of the layer of material 5658relative to the cartridge body 5450. Further, the reinforcement feature5670 can engage tissue clamped between the first jaw and the second jaw5602 of the end effector assembly 5600. For example, the reinforcementfeature 5670 can prevent and/or limiting shifting of the clamped tissuerelative to the cartridge body 5450. The pointed tip 5672 can engage thetissue, and can hold the tissue in place relative to the layer ofmaterial 5658 during the firing stroke, for example. In variousembodiments, the layer of material 5658 can include multiplereinforcement features 5670 which can extend along at least a portion ofthe length of the layer of material 5658. The reinforcement features5670 can be parallel, for example, and can extend on either side or bothsides of the ridge 5660, for example.

Referring now to FIGS. 76 and 77, an end effector assembly 5700 caninclude a first jaw, illustrated elsewhere, and a second jaw 5702. Invarious embodiments, the second jaw 5702 can include a cartridge body5750 and a layer of material 5758 releasably secured to the cartridgebody 5750 and/or to the second jaw 5702. In various embodiments, thecartridge body 5750 and the layer of material 5758 releasably securedthereto can comprise a fastener cartridge assembly, for example. Thelayer of material 5758 can comprise a piece of buttress material and/ora tissue thickness compensator, for example. In certain embodiments, thelayer of material 5758 can be a piece of buttress material releasablysecured to the cartridge body 5750, for example. The second jaw 5702 canhave a proximal portion 5704 and a distal portion 5706. In variousembodiments, the second jaw 5702 can have a proximal connector 5780 a(FIG. 77) at the proximal portion 5704 and a distal connector 5780 b(FIG. 77) at the distal portion 5706. The proximal connector 5780 a andthe distal connector 5780 b can secure the layer of material 5758relative to the cartridge body 5750.

Referring primarily to FIG. 76, the cartridge body 5750 can include adeck 5752. A slot 5756 can extend from the proximal portion 5704 towardthe distal portion 5706 of the second jaw 5702, and can be defined in aportion of the deck 5752, for example. In various embodiments, fastenercavities 5754 can be defined in the deck 5752. The second jaw 5702 canalso include fasteners, such as surgical staplers, removably positionedin the fastener cavities 5754. For example, a fastener can be ejectablypositioned in each fastener cavity 5754 of the cartridge body 5750. Invarious embodiments, the fasteners can be ejected from their respectivefastener cavities 5754 in the cartridge body 5750 by a sled, similar tosled 5434 (FIGS. 65 and 66) during a firing stroke.

Referring still to FIGS. 76 and 77, a firing assembly, such as thefiring assembly 5430 (FIGS. 65 and 66) can move along the slot 5756 inthe cartridge body 5750 during the firing stroke. As describedpreviously, the firing assembly 5430 can include a firing bar 5432, acutting edge 5436, and a foot 5438 (FIGS. 65 and 66), for example. Invarious embodiments, the firing assembly 5430 can engage the sled in thecartridge body 5730 and can drive the sled at least partially throughthe cartridge body 5750 during the firing stroke. In certainembodiments, the sled can have a camming surface or ramp, which canengage drivers in the fasteners cavities 5754 during the firing stroke.When the ramp engages a driver in a fastener cavity 5754, the ramp cancam the driver and corresponding fastener toward the cartridge deck5752, and can eject the fastener from the fastener cavity 5754, forexample. In various embodiments, the cutting edge 5436 can cut theproximal connector 5780 a and the distal connector 5780 b (FIG. 77)during the firing stroke. The cutting edge 5436 can cut the proximalconnector 5780 a at or near the beginning of the firing stroke, forexample, and can cut the distal connector 5780 b at or near the end ofthe firing stroke, for example.

Referring still to FIGS. 76 and 77, the layer of material 5758 can bereleasably secured to the deck 5752 of the cartridge body 5750 by theproximal connector 5780 a and by the distal connector 5780 b (FIG. 77).In various embodiments, the cartridge body 5750 can include at least onenotch 5748 a (FIG. 76), which can be defined in the deck 5752, forexample. The notch 5748 a can be positioned between the proximalconnector 5780 a and the distal connector 5780 b, for example. Further,in various embodiments, the layer of material 5758 can include a mount5760 a (FIG. 76), which can be integrally molded with the layer ofmaterial 5758, for example. In certain embodiments, when the layer ofmaterial 5758 is secured to the deck 5752, the mount 5760 a can extendfrom the layer of material 5758 into the notch 5748 a of the cartridgebody 5750. The mount 5760 a can remain positioned within the notch 5748a to hold the layer of material 5758 relative to the deck 5752 of thecartridge body 5750. The mount 5760 a can be sized to fit in the notch5748 a when the layer of material 5758 is positioned on the cartridgebody 5750. Furthermore, the mount 5760 a can be sized for unforcedremoval from the notch 5748 a when the layer of material 5758 is liftedand/or peeled away from the cartridge body 5758. For example, the mount5760 may not be friction fit in the notch 5748 a, and, in certainembodiments, when the mount 5760 a is positioned in the notch 5748 a, aclearance or gap can exist between the mount 5760 a and the notch 5748a. The clearance can be approximately 0.08 mm, for example. In certainembodiments, the clearance can be up to approximately 0.24 mm, forexample. In some embodiments, an interference of approximately 0.01 mmto approximately 0.06 mm can exist between the mount 5760 a and thenotch 5748 a, for example, such that the mount 5760 a is compressed whenpositioned in the notch 5748 a, for example.

In various embodiments, the mount-notch engagement can prevent and/orlimit lateral shifting and/or buckling of the layer of material 5758relative to the cartridge body 5750. For example, when the end effectorassembly 5700 is placed and/or moved relative to tissue at a surgicalsite and/or when the cutting edge 5436 (FIGS. 65 and 66) cuts the layerof material 5758, the mount 5760 a can remain positioned in the notch5748 a to hold the layer of material 5758 in position relative to thecartridge deck 5752. In certain embodiments, shifting of the layer ofmaterial 5758 relative to the cartridge body 5750 can be limited by theclearance defined between the mount 5760 a and the notch 5748 a. Forexample, some shifting of the layer of material 5758 may be possibleowing to the clearance. Further, after the cutting edge 5436 cuts theproximal connector 5780 a and the distal connector 5780 b, the mount5760 a can smoothly disengage and/or be removed from the notch 5748 a asthe layer of material 5758 is lifted and/or peeled away from thecartridge body 5750.

Referring primarily to FIG. 76, the cartridge body 5750 can include atleast one pair of notches 5748 a, 5748 b, and the layer of material 5758can include a pair of mounts 5760 a, 5760 b. The first notch 5748 a canbe positioned on a first longitudinal side of the cartridge body 5750,for example, and the second notch 5748 b can be positioned on a secondlongitudinal side of the cartridge body 5750, for example. In otherwords, each notch of the pair of notches 5748 a, 5748 b can bepositioned on opposite sides of the slot 5756 in the cartridge body5750. In certain embodiments, the second notch 5748 b can be a mirrorimage reflection of the first notch 5748 a across the slot 5756, forexample. Further, when the layer of material 5758 is secured to thecartridge body 5750, each mount of the pair of mounts 5760 a, 5760 b canbe aligned with a notch of the pair of notches 5748 a, 5748 b such thatthe first mount 5760 a extends into the first notch 5748 b and thesecond mount 5760 b extends into the second notch 5748 b. In variousembodiments, the pair of notches 5748 a, 5748 b in the cartridge body5750 can be positioned at the perimeter of the cartridge body 5750.Further, in certain embodiments, the pair of mounts 5760 a, 5760 b canbe positioned at the perimeter of the layer of material 5758.

In various embodiments, the mount-notch engagement on both sides of thecartridge body 5750 can further prevent and/or limit lateral shiftingand/or buckling of both longitudinal sides of the layer of material5758. For example, when the cutting edge 5436 of the firing assembly5430 (FIGS. 65 and 66) cuts the layer of material 5758, the pair ofmounts 5760 a, 5760 b can remain positioned in the pair of notches 5748a, 5748 b to hold the perimeter of the layer of material 5758 inposition relative to the perimeter of the cartridge deck 5752. In otherwords, the pair of mounts 5760 a, 5760 b can prevent at least a portionof the layer of material 5758 from slipping laterally relative to thecartridge deck 5752. Further, as the layer of material 5758 is liftedand/or peeled away from the cartridge body 5750, for example, after thecutting edge 5436 cuts the proximal and distal connectors, the pair ofmounts 5760 a, 5760 b can be easily and smoothly removed from the pairof notches 5748 a, 5748 b. In various embodiments, the layer of material5758 can include multiple pairs of mounts 5760 a, 5860 b, and thecartridge body 5750 can include multiple pairs of notches 5748 a, 5748b. When the layer of material 5758 is secured to the cartridge body5750, each pair of mounts 5760 a, 5760 b of the layer of material 5758can be aligned with a pair of notches 5748, for example. In suchembodiments, the mount-notch engagement along a length of the perimeterof the lower jaw 5702 can further prevent and/or limit lateral shiftingand/or buckling of a length of the layer of material 5758 relative tothe cartridge body 5750.

Referring now to FIGS. 78-80, an end effector assembly 5800 can includea first jaw, illustrated elsewhere, and a second jaw 5802. In variousembodiments, the second jaw 5802 can include a cartridge body 5850 and alayer of material 5858 releasably secured to the cartridge body 5850and/or to the second jaw 5802. In various embodiments, the cartridgebody 5850 and the layer of material 5858 releasably secured thereto cancomprise a fastener cartridge assembly, for example. The layer ofmaterial 5858 can comprise a piece of buttress material and/or a tissuethickness compensator, for example. In certain embodiments, the layer ofmaterial 5858 can be a piece of buttress material releasably secured tothe cartridge body 5850, for example. The second jaw 5802 can have aproximal portion 5804 and a distal portion 5806. In various embodiments,the second jaw 5802 can have a proximal connector, similar to proximalconnector 5780 a (FIG. 77), at the proximal portion 5804 and a distalconnector, similar to distal connector 5880 b (FIG. 77), at the distalportion 5406. The proximal connector and the distal connector can securethe layer of material 5858 relative to the cartridge body 5850.

Referring primarily to FIG. 78, the cartridge body 5850 can include adeck 5852. A slot 5856 can extend from the proximal portion 5804 towardthe distal portion 5806 of the second jaw 5802, and can be defined in aportion of the deck 5852, for example. In various embodiments, fastenercavities 5854 can be defined in the deck 5852. The second jaw 5802 canalso include fasteners, such as surgical staplers, removably positionedin the fastener cavities 5854. For example, a fastener can be ejectablypositioned in each fastener cavity 5854 of the cartridge body 5850. Invarious embodiments, the fasteners can be ejected from their respectivefastener cavities 5854 in the cartridge body 5850 by a sled, similar tosled 5434 (FIGS. 65 and 66) during a firing stroke.

A firing assembly, such as firing assembly 5430 (FIGS. 65 and 66) canmove along the slot 5856 in the cartridge body 5850 during the firingstroke. The firing assembly 5430 can include a firing bar 5432, acutting edge 5436, and a foot 5438, for example. In various embodiments,the firing assembly 5430 can engage the sled in the cartridge body 5850and can drive the sled at least partially through the cartridge body5850 during the firing stroke. In certain embodiments, the sled can havea camming surface or ramp, which can engage drivers in the fastenerscavities 5854 during the firing stroke. When the ramp engages a driverin a fastener cavity 5854, the ramp can cam the driver and thecorresponding fastener toward the cartridge deck 5852, and can eject thefastener from the fastener cavity 5854, for example. In variousembodiments, the cutting edge 5436 can cut the proximal and distalconnectors during the firing stroke. The cutting edge 5436 can cut theproximal connector at or near the beginning of the firing stroke, forexample, and can cut the distal connector at or near the end of thefiring stroke, for example.

Referring still to FIGS. 78-80, the cartridge body 5850 can include atleast one notch 5848, which can be defined in the deck 5852 (FIG. 78),for example. The notch 5848 can be positioned between the proximalconnector and the distal connector, for example. Further, in variousembodiments, the layer of material 5858 can include a pair of mounts5860 a, 5860 b. The pair of mounts 5860 a, 5860 b can be integrallymolded with the layer of material 5858, for example. In certainembodiments, when the layer of material 5858 is secured to the deck5852, the pair of mounts 5860 a, 5860 b can extend from the layer ofmaterial 5858 into the notch 5848 of the cartridge body 5850. The pairof mounts 5860 a, 5860 b can be positioned the notch 5848 to hold thelayer of material 5858 relative to the deck 5852 of the cartridge body5850. In various embodiments, the pair of mounts 5860 a, 5860 b can besized to fit in the notch 5848 when the layer of material 5858 ispositioned on the cartridge body 5850. Furthermore, the pair of mounts5860 a, 5860 b can be sized for unforced removal from the notch 5848when the layer of material 5858 is lifted and/or peeled from thecartridge body 5858. In certain embodiments, when the pair of mounts5860 a, 5860 b are positioned within the notch 5848, a clearance or gapcan exist between each mount 5860 a, 5860 b and the notch 5848. Theclearance can be approximately 0.12 mm, for example. In certainembodiments, the clearance can be up to approximately 0.24 mm, forexample. In some embodiments, an interference of approximately 0.01 mmto approximately 0.18 mm can exist between the each mount 5860 a, 5860 band the notch 5848, for example, such that each mount 5860 a, 5860 b iscompressed when positioned in the notch 5848, for example.

In various embodiments, the mount-notch engagement can prevent and/orlimit lateral shifting and/or buckling of the layer of material 5858.For example, when the cutting edge 5436 (FIGS. 65 and 66) cuts the layerof material 5858, the pair of mounts 5860 a, 5860 b can remainpositioned in the notch 5848 to hold the layer of material 5858 inposition relative to the cartridge deck 5852. Shifting of the layer ofmaterial 5858 relative to the cartridge body 5850 can be limited by theclearance defined between each mount 5860 a, 5860 b and the notch 5848,for example. For example, some shifting of the layer of material 5858may be possible owing to the clearance. In various embodiments, themounts 5860 a, 5860 b may not resist lifting and/or peeling of the layerof material 5858 away from the cartridge body 5850. For example, themounts 5860 a, 5860 b may not be friction fit in the notch 5848, and themounts 5860 a, 5860 b can be easily and smoothly removed from the notch5848 when the layer of material is lifted away from the deck of thecartridge body 5850, for example, after the cutting edge 5436 cuts theproximal and distal connectors.

Referring primarily to FIG. 78, the notch 5848 can extend from the slot5856 in the cartridge body 5850, and can intersect the slot 5856, forexample. In such embodiments, when the pair of mounts 5860 a, 5860 bextends into the notch 5848, the mount 5860 a can be positioned on afirst side of the slot 5856 and the mount 5860 b can be positioned on asecond side of the slot 5856, for example. In certain embodiments, themount 5860 b can be a mirror image reflection of the mount 5860 b acrossthe slot 5856, for example. Further, referring primarily to FIG. 79, thepair of mounts 5860 a, 5860 b may not overlap the slot 5856, forexample. In such embodiments, the cutting edge 5436 of the firingassembly 5430 (FIGS. 65 and 66) can transect the layer of material 5858during the firing stroke without cutting the mounts 5860 a, 5860 b, forexample. In other words, the firing assembly 5430 can pass between thepair of mounts 5860 a, 5860 b during the firing stroke. In suchembodiments, the mount-notch engagement on both sides of the slot 5856can further prevent and/or limit lateral shifting and/or buckling ofboth longitudinal sides of the layer of material 5858, for example.Referring primarily to FIG. 78, the cartridge body 5850 can includemultiple notches 5848 spaced along a portion of the length of thecartridge body 5850. Further, the layer of material 5858 can includemultiple pairs of mounts 5860 a, 5860 b. When the layer of material 5858is secured to the cartridge body 5850, the pairs of mounts 5860 a, 5860b of the layer of material 5758 can be aligned with the notches 5748,for example. In such embodiments, the mount-notch engagement along aportion of the length of the lower jaw 5802 can further prevent and/orlimit lateral shifting and/or buckling of a length of the layer ofmaterial 5858.

Referring now to FIGS. 80A and 80B, a layer of material 5958 for usewith an end effector can have a perimeter 5970 that defines the edge ofthe layer of material 5958. In various embodiments, the layer ofmaterial 5958 can be a piece of buttress material or a tissue thicknesscompensator, for example. Further, the perimeter 5970 can includecontours 5974 and indentations 5972. In various embodiments, anindentation 5972 can be positioned intermediate each contour 5974 toform a scalloped edge along at least a portion of the perimeter 5970. Invarious embodiments, the perimeter can be a scalloped perimeter. Incertain embodiments, a portion of the perimeter 5970 can be a scallopedperimeter, and a portion of the perimeter can be a non-scallopedperimeter. The scalloped edge of the perimeter 5970 can prevent and/orlimit abrasions and/or other damage to tissue that contacts theperimeter 5970 while the layer of material 5958 is positioned relativeto the surgical site.

Referring still to FIGS. 80A and 80B, the layer of material 5958 caninclude a top surface 5962 (FIG. 80A) and a bottom surface 5966 (FIG.80B). The top surface 5962 can be positioned relative to the first jawor anvil of an end effector, for example, and the bottom surface 5966can be positioned relative to a second jaw or fastener cartridge of theend effector, for example. In various embodiments, the layer of material5958 can include a proximal portion 5904 and a distal portion 5906. Incertain embodiments, the layer of material 5958 can include a mount5960, 5964 extending from the top surface 5962 and/or the bottom surface5966 thereof. In various embodiments, the mount 5960, 5964 can bepositioned in an indentation or notch in the end effector 5902, such asa notch in the cartridge body and/or in the anvil. In certainembodiments, the mount 5960, 5964 can support, reinforce and/or rigidifythe layer of material 5958. For example, when the cutting edge 5436(FIGS. 65 and 66) traverses the layer of material 5958 during a firingstroke, the mount 5960 can prevent and/or limit shifting and/or bucklingof the layer of material 5958 relative to the cartridge body. Further,one of the mounts 5960, 5964 can engage tissue clamped between the firstjaw and the second jaw of the end effector 5902, for example. In suchembodiments, the mount 5960, 5964 can prevent and/or limiting shiftingof the clamped tissue relative to the cartridge body, for example.Referring primarily to FIG. 80A, the mount 5960 can be at the distalportion 5906 of the layer of material 5958. The mount 5960 can includemultiple projections or buttons extending from the top surface 5962, forexample. In various embodiments, the buttons of the mount 5960 can bearranged in a triangle, for example. Referring primarily to FIG. 80B,the mount 5964 can extend from the bottom surface 5966 of the layer ofmaterial 5958, for example. The mount 5964 can be at the distal portion5906 of the layer of material 5958, and can be V-shaped, for example.

Referring now to FIGS. 81-84, an end effector assembly 5000 can includea first jaw, illustrated elsewhere, and a second jaw 5002. In variousembodiments, the second jaw 5002 can include a fastener cartridgeassembly comprising a fastener cartridge body 5050 and a layer ofmaterial 5058 releasably secured to the fastener cartridge body 5050. Invarious embodiments, the layer of material 5058 can comprise a tissuethickness compensator and/or piece of buttress material. For example,the layer of material 5058 can be a piece of buttress materialreleasably secured to the fastener cartridge body 5050. Referringprimarily to FIG. 81, the fastener cartridge body 5050 can have fastenercavities 5054 defined therein. Further, the second jaw 5002 and/or thefastener cartridge body 5050 can include fasteners, such as surgicalstaples, for example, which can be removably positioned in the fastenercavities 5054. For example, a fastener can be ejectably positioned ineach fastener cavity 5054 of the cartridge body 5050. In certainembodiments, the cartridge body 5050 can include a slot 5056, which canextend from a proximal portion 5004 of the second jaw 5002 toward adistal portion 5006 of the second jaw 5002. In various embodiments, afiring assembly 5030 can translate along the slot 5056 of the cartridgebody 5050. For example, the firing assembly 5030 can translate withinthe slot 5056 during a firing stroke, and can eject the fasteners fromthe fastener cavities 5054 during the firing stroke.

Referring still to FIGS. 81-84, the firing assembly 5030 can include afiring bar, a cutting edge 5036 (FIGS. 81 and 82), a crossbar 5038(FIGS. 81 and 82), a nose 5040 (FIG. 81) and a foot 5034. The cuttingedge 5036 can cut tissue and/or cut the layer of material 5058 as thefiring assembly 5030 is fired through the second jaw 5002 during afiring stroke. The crossbar 5038 can engage the first jaw, such as aslot in the anvil thereof, to hold the first jaw relative to thecartridge body 5050, and the foot 5034 can engage the second jaw 5002,such as the slot 5056 (FIG. 81) in the cartridge body 5050, to hold thefiring assembly 5030 relative to the cartridge body 5050, for example.In various embodiments, the firing assembly 5030 can engage a sled inthe cartridge body 5050 during the firing stroke. An element of thefiring assembly 5030, such as the nose 5040, for example, can engage thesled and push the sled distally during the firing stroke to ejectfasteners from the fastener cavities 5054, for example.

Referring primarily to FIG. 81, the layer of material 5058 can bereleasably secured to the cartridge body 5050 by at least one connector.In certain embodiments, multiple connectors can secure the layer ofmaterial 5058 to the cartridge body 5050. For example, a proximalconnector can secure the layer of material 5058 to the cartridge body5050 at the proximal portion 5004 of the second jaw 5002, and a distalconnector 5080 can secure the layer of material 5058 to the cartridgebody 5050 at the distal portion 5006 of the second jaw 5002. In variousembodiments, a mount 5064 can extend from the layer of material 5058 atthe distal portion of the second jaw 5002. The distal connector 5080 canextend or wrap around at least part of the second jaw 5002 and/or thecartridge body 5050, as well as the mount 5064 to hold the layer ofmaterial 5058 relative to the cartridge body 5050, for example. Incertain embodiments, additional connectors can secure the layer ofmaterial 5058 to the cartridge body 5050. In such embodiments, theadditional connectors can be spaced along at least a portion of thelength of the cartridge body 5050, and can be positioned between theproximal connector and the distal connector 5080, for example. Invarious embodiments, a connector can be a band, a tie, and/or a suture,and can include braided and/or intertwined fibers, for example. The endof a cut and/or severed connector may be sharp, for example, and maypierce and/or lacerate adjacent tissue as the surgeon removes the endeffector assembly from the patient's tissue. However, the end of abraided connector can be less sharp than the end of a non-braidedconnector. For example, the cut end of a braided connector may fray,which can result in a less sharp end. With braided connectors,puncturing and/or lacerations to the tissue by the cut and/or severedend of the connector can be reduced and/or substantially eliminated. Invarious embodiments, a braided connector can have at least substantiallythe same tensile holding strength as a non-braided connector, forexample. Further, in certain embodiments, when cut and/or severed, abraided connector can have substantially less compressive strength thana non-braided connector, for example.

Still referring primarily to FIG. 81, the distal connector 5080 can holdthe layer of material 5058 relative to the cartridge body 5050. Thelayer of material 5058 can be released from the cartridge body 5050 whenthe distal connector 5080, as well as any additional connectors, arebroken, cut, dislodged or otherwise overcome. In certain embodiments,the firing assembly 5030 can overcome the distal connector 5080 as thefiring assembly 5030 translates along the slot 5056 in the fastenercartridge 5050 during a firing stroke. For example, during the firingstroke, the firing assembly 5030 can cut tissue clamped between thefirst jaw and the second jaw 5002, and can also move the fasteners fromthe fastener cavities 5054 into the clamped tissue and the layer ofmaterial 5058. In various embodiments, the firing assembly 5030 can pushthe sled distally during the firing stroke. The sled can have a cammingsurface or ramp, for example, which can engage drivers in the fastenercavities 5054. When the ramp engages a driver, the ramp can push thedriver toward the layer of material 5058 to eject the fastener from thefastener cavity 5054. Further, the firing assembly 5030 can cut thelayer of material 5058 and/or the distal connector 5080 during thefiring stroke.

Referring still to FIGS. 81-84, in various embodiments, the second jaw5002 can overcome the connector or connectors, such as or including thedistal connector 5080, at or near the beginning of the firing stroke. Inother words, an element of the second jaw 5002 can overcome the distalconnector 5080 at or near the beginning of the firing stroke. The secondjaw 5002 and/or the fastener cartridge assembly can include an actuator5010, for example, which can overcome the distal connector 5080 beforethe fasteners are ejected from the fastener cavities 5054. The actuator5010 can overcome the distal connector 5080, and the layer of material5058 can be released from the cartridge body 5050 even when the firingstroke terminates prematurely, i.e., before the firing assembly 5030reaches the distal portion 5006 of the second jaw 5002, for example. Invarious embodiments, the actuator 5010 can include a bottom side 5016,sidewalls 5018, and/or rims 5026. The sidewalls 5018 can extend from thebottom side 5016 and around at least a portion of the cartridge body5050. The rims 5026 can extend from the sidewalls 5018 and around atleast a portion of the cartridge body 5050. In various embodiments, therims 5026 can extend into slits 5052 in the cartridge body 5050, forexample. The bottom side 5016, the sidewalls 5018, and/or the rims 5026can extend past and/or around the cartridge body 5050 and the fastenerspositioned in the fastener cavities 5054 thereof. Further, the actuator5010 can be moveably held relative to the cartridge body 5050. Forexample, the actuator 5010 can move from a pre-actuated position (FIG.81) to an actuated position (FIG. 82). In certain embodiments, the rims5026 of the actuator 5010 can slide in the slits 5052 in the cartridgebody 5050 when the actuator 5010 moves relative to the cartridge body5050. When the actuator 5010 moves relative to the cartridge body 5050,the actuator 5010 can slide relative to the fasteners positioned in thefastener cavities 5054 of the cartridge body 5050. For example, theactuator 5010 can slide past and/or around the fasteners positioned inthe cartridge body 5050.

Referring primarily to FIGS. 81-84, the actuator 5010 can include a slot5012, which can extend from the proximal portion 5004 toward the distalportion 5006 of the second jaw 5002 when the actuator 5010 is positionedrelative to the cartridge body 5050. The slot 5012 in the actuator 5010can correspond to and/or be aligned with the slot 5056 (FIG. 81) in thecartridge body 5050, for example. Further, the firing assembly 5030 cantranslate within the slot 5012 in the actuator 5010 as the firingassembly 5030 translates within the slot 5056 in the cartridge body 5050during the firing stroke. In various embodiments, the firing assembly5030 can engage the actuator 5010 to move the actuator 5010 distallywhen the firing assembly 5030 is at or near the beginning of the firingstroke. In such embodiments, the firing assembly 5030 can actuate theactuator 5010 at the proximal portion 5004 of the second jaw 5002. Whenthe actuator 5010 is actuated and moves distally, a distal end of theactuator 5010 can cut or otherwise overcome the distal connector 5080,for example. In other words, the proximal actuation of the actuator 5010can effectuate the distal release of the layer of material 5058 from thecartridge body 5050. In various embodiments, the actuator 5010 canmerely shift distally to overcome the distal connector 5080. In at leastone embodiment, the actuator 5010 can shift approximately 1.0 mm beforeovercoming the distal connector 5080. In certain embodiments, theactuator 5010 can shift approximately 0.5 mm to approximately 5.0 mmbefore overcoming the distal connector 5180.

Referring primarily to FIGS. 81 and 82, the actuator 5010 can move fromthe pre-actuated position (FIG. 81) to the actuated position (FIG. 82)when the firing assembly 5030 moves between an unfired position and apartially fired position during part of the firing stroke. In variousembodiments, the slot 5012 in the actuator 5010 can include a releasestop 5014. The release stop 5014 can include a frangible bridge acrossthe slot 5012, for example. Referring primarily to FIG. 82, an elementof the firing assembly 5030 can push against the release stop 5014 asthe firing assembly 5030 translates along the slot 5056 (FIG. 81) duringthe firing stroke. The firing assembly 5030 can push against the releasestop 5014 at or near the beginning of the firing stroke, for example. Incertain embodiments, the release stop 5014 can be near the proximal endof the slot 5012, and an element of the firing assembly 5030, such asthe nose 5040, can abut the release stop 5014 upon the initiation of thefiring stroke. When the nose 5040 is positioned against the release stop5014, the nose 5040 can push against the actuator 5010 and move theactuator 5010 distally. In certain embodiments, referring primarily toFIG. 82, the actuator 5010 can be moved distally until it reaches a hardstop 5060, for example. The hard stop 5060 can be at the distal portion5006 of the second jaw 5002, and can prevent further distal movement ofthe actuator 5010, for example. In various embodiments, the actuator5010 can abut the hard stop 5060 before the firing assembly 5030 ejectsthe fasteners from the fastener cavities 5054. In certain embodiments,the actuator can abut the hard stop 5060 as the firing assembly 5030ejects at least one fastener from a fastener cavity 5054 and/or afterthe firing assembly 5030 ejects at least one fastener from a fastenercavity 5054.

Referring still to FIG. 82, when the actuator 5010 is pushed distally bythe firing assembly 5030, the actuator 5010 can cut or otherwiseovercome the distal connector 5080 to release the layer of material 5058from the cartridge body 5050 at the distal portion 5006 of the secondjaw 5002. In certain embodiments, the actuator 5010 can include a notch5024 for receiving and holding the distal connector 5080. The notch 5024can hold the distal connector 5080 as the actuator 5010 shifts distallytoward the hard stop 5060. Further, the actuator 5010 can include acutting edge 5020, for example, along a portion of the notch 5024. Incertain embodiments, when the actuator 5010 moves toward the hard stop5060, the distal connector 5080 can be pushed between the hard stop 5060and the cutting edge 5020 of the actuator 5010. In various embodiments,the cutting edge 5020 can cut the distal connector 5080 when the cuttingedge 5020 is pushed into the hard stop 5060. In such embodiments, thedistal connector 5080 can be cut by the cutting edge 5020 of theactuator 5010 at or near the beginning of the firing stroke and beforethe fasteners are fired from the fastener cavities 5054. In variousembodiments, the actuator 5010 can overcome the distal connector 5080without cutting it. For example, the actuator 5010 can dislodge orstretch the distal connector 5080 out of position such that the distalconnector 5080 no longer holds the layer of material 5058 relative tothe cartridge body 5050. In various embodiments, distal movement of theactuator 5010 can overcome or unlock a restraint, such as a cam-lock,that locks and/or tightens the distal connector 5080 around the layer ofmaterial 5058. For example, referring to FIG. 30, a restraint 694 can bepositioned in the lower jaw 680 and, for example, can be positionedbetween the pan 680 a and the cartridge body 682. In variousembodiments, the restraint 694 can be used when assembling the endeffector, and the connector S3 can be connected thereto. When therestraint 694 is pushed and secured in place, the restraint 694 cantighten the connector S3 around the layer B2, and can be adjustablypositioned to adjust the tightness of the connector S3 around the layerB2. In various embodiments, referring again to FIG. 82, the actuator5010 can unlock a restraint, such as restraint 694 (FIG. 30), forexample. The actuator 5010 can cam the restraint, such that therestraint loosens and/or releases the distal connector 5080.

In various embodiments, additional connectors along the length of thecartridge body 5050 can be cut or otherwise overcome by the actuator5010 at or near the beginning of the firing stroke. For example, aproximal cutting edge on the actuator 5010 can cut an additionalproximal connector, and/or an intermediate cutting edge on the actuator5010 can cut an additional immediate connector. The various cuttingedges and/or portions of the actuator 5010 can cut or otherwise overcomeeach of the connectors at and/or near the beginning of the firingstroke. Additionally or alternatively, the cutting edge 5036 of thefiring assembly 5030 can cut or otherwise overcome the additionalconnectors. For example, the cutting edge 5036 of the firing assembly5030 can cut a connector at the proximal portion 5004 of the second jaw5002 and the cutting edge 5020 of the actuator 5010 can cut the distalconnector 5080 before the fasteners are ejected from the fastenercavities 5054 of the cartridge body 5050. In certain embodiments, theactuator 5010 can over the distal connector 5080 as at least onefastener is ejected from a fastener cavity 5054 and/or after at leastone fastener is ejected from a fastener cavity 5054.

Referring primarily to FIGS. 83 and 84, when the actuator 5010 isblocked from further distal movement by the hard stop 5060, the firingassembly 5030 can push through the release stop 5014 in the slot 5012 ofthe actuator 5010. For example, the nose 5040 of the firing assembly5030 can break the frangible bridge of the release stop 5014 to continuemoving distally along the slot 5012 during the firing stroke. Thefrangible bridge can be sufficiently rigid to withstand the force of thefiring assembly 5030 as the actuator 5010 shifts distally toward thehard stop 5060, and can be sufficiently frangible to break when theactuator 5010 reaches the hard stop 5060 without requiring excessiveforce by a motor and/or an operator. The actuator 5010 and/or thefrangible bridge thereof can comprise stainless steel, titanium,aluminum, liquid crystal polymer (LCP), nylon and/or ultem, for example.In certain embodiments, the actuator 5010 can comprise stainless steeland the frangible bridge can comprise a thin piece of stainless steel.In certain embodiments, the frangible bridge can include a perforation,which can increase the frangibility thereof. The size and shape of theperforation can be selected such that the frangible bridge isappropriately breakable. In various embodiments, the actuator 5010 canovercome the distal connector 5080 before a fastener is fired from thefastener cartridge 5050. In certain embodiments, at least one fastenercan be fired from a fastener cavity before or while the actuator 5010overcomes the distal connector 5080. Upon breaking through the releasestop 5014, the firing assembly 5030 can continue to move distally alongthe slot 5056 (FIG. 81) in the cartridge body 5050 and along the slot5012 in the actuator 5010 to eject fasteners from the fastener cartridge5050 during the remaining portion of the firing stroke. Stateddifferently, the firing assembly 5030 can actuate the actuator during afirst stage or portion of the firing stroke, and can fire fasteners fromthe fastener cavities 5054 and/or cut tissue and/or the layer ofmaterial 5058 during a second stage or portion of the firing stroke.

Referring now to FIGS. 85 and 86, an end effector assembly can include afirst jaw 5102 and a second jaw, illustrated elsewhere. In variousembodiments, the first jaw 5102 can include an anvil frame 5170 and alayer of material releasably secured to the anvil frame 5170. The layerof material can comprise a tissue thickness compensator and/or a pieceof buttress material, for example, similar to the layer of material 5058(FIGS. 81-84). For example, the layer of material can be a piece ofbuttress material releasably secured to the anvil frame 5170. In certainembodiments, the anvil frame 5170 can include a slot 5172, which canextend from a proximal portion 5104 of the first jaw 5102 toward adistal portion 5106 of the first jaw 5102. In various embodiments, afiring assembly 5130 can translate along the slot 5172 of the anvilframe 5170. For example, the firing assembly 5130 can translate alongthe slot 5172 during a firing stroke. The translation of the firingassembly 5130 along the slot 5172 can correspond to the translation of afiring element through the second jaw of the end effector assembly. Asthe firing element translates through the second jaw, for example, thefiring element can eject fasteners from the second jaw into the layer ofmaterial and the tissue clamped between the first jaw 5102 and thesecond jaw. Referring primarily to FIG. 85, the firing assembly 5130 caninclude a firing bar 5132 and a nose 5136. In various embodiments, thenose 5136 of the firing assembly 5130 can include a cutting edge forcutting tissue and the layer of material clamped between the first jaw5102 and the second jaw.

Referring primarily to FIG. 85, the layer of material can be releasablysecured to the anvil frame 5170 by at least one connector. In certainembodiments, multiple connectors can secure the layer of material to theanvil frame 5170. For example, a proximal connector can secure the layerof material to the anvil frame 5170 at the proximal portion 5104 of thefirst jaw 5102, and a distal connector 5180 can secure the layer ofmaterial to the anvil frame 5170 at the distal portion 5106 of the firstjaw 5102. In certain embodiments, additional connectors can secure thelayer of material to the anvil frame 5170. In such embodiments, theadditional connectors can be spaced along at least a portion of thelength of the anvil frame 5170, and can be positioned between theproximal connector and the distal connector 5180, for example.

Still referring primarily to FIG. 85, the distal connector 5180 can holdthe layer of material relative to the anvil frame 5170. The layer ofmaterial can be released from the anvil frame 5170 when the distalconnector 5180 and any additional connectors are broken, cut, dislodgedor otherwise overcome. In certain embodiments, the firing assembly 5130can overcome the distal connector 5180 as the firing assembly 5130translates along the slot 5172 in the anvil frame 5170 during a firingstroke. In various embodiments, an element of the first jaw 5102 canovercome the connector or connectors, such as or including distalconnector 5180, at or near the beginning of the firing stroke. In otherwords, the first jaw 5102 can overcome the distal connector 5180 at ornear the beginning of the firing stroke and before a fastener is ejectedinto the clamped tissue. In various embodiments, the first jaw 5102 caninclude an actuator 5110, for example, which can overcome the distalconnector 5080 at or near the beginning of the firing stroke. Theactuator 5110 can overcome the distal connector 5180, and the layer ofmaterial 5158 can be released from the anvil frame 5170 even when thefiring stroke terminates prematurely, i.e., before the firing assembly5130 reaches the distal portion 5106 of the first jaw 5102, for example.In various embodiments, the actuator 5110 can comprise a longitudinalplate that extends along a length of the anvil frame 5170. In certainembodiments, the plate can include a longitudinal portion on one side ofthe anvil slot 5172, another longitudinal portion on another side of theanvil slot 5172, and a distal bridge 5174 extending between thelongitudinal portions to reinforce the distal end of the actuator 5110.The actuator 5110 can extend through the first jaw 5102, and can bepositioned between a fastener forming surface and an outer surface ofthe first jaw 5102, for example. Further, the actuator 5110 can bemoveably held relative to the anvil frame 5170. For example, theactuator 5110 can move from a pre-actuated position (FIG. 85) to anactuated position (FIG. 86).

Referring primarily to FIG. 85, the actuator 5110 can include a slot5112, which can extend from the proximal portion 5104 toward the distalportion 5106 of the first jaw 5102 when the actuator 5110 is positionedrelative to the anvil frame 5170. The slot 5112 in the actuator 5110 cancorrespond to and/or be aligned with the slot 5172 in the anvil frame5170, for example. Further, the firing assembly 5130 can translate alongthe slot 5112 in the actuator 5110 as the firing assembly 5130translates along the slot 5172 in the anvil frame 5170 during the firingstroke. In various embodiments, the firing assembly 5130 can engage theactuator 5110 to move the actuator 5110 distally when the firingassembly 5130 is at or near the beginning of the firing stroke. In suchembodiments, the firing assembly 5130 can actuate the actuator 5110 atthe proximal portion 5104 of the first jaw 5102. When the actuator 5110is actuated and moves distally, a distal end of the actuator 5110 cancut or otherwise overcome the distal connector 5180, for example. Inother words, the proximal actuation of the actuator 5110 can effectuatethe distal release of the layer of material from the anvil frame 5172.In various embodiments, the actuator 5110 can merely shift distally toovercome the distal connector 5180. In at least one embodiment, theactuator 5110 can shift approximately 1.0 mm before overcoming thedistal connector 5180. In certain embodiments, the actuator 5110 canshift approximately 0.5 mm to approximately 5.0 mm before overcoming thedistal connector 5180

Referring still to FIGS. 85 and 86, the actuator 5110 can move from thepre-actuated position (FIG. 85) to the actuated position (FIG. 86) whenthe firing assembly 5130 moves between an unfired position and apartially fired position during part of the firing stroke. In variousembodiments, the slot 5112 in the actuator 5110 can include a releasestop 5114. The release stop 5114 can have a narrower width than theportions of the slot 5112 adjacent to the release stop 5114, forexample. Referring primarily to FIG. 85, an element of the firingassembly 5130 can push against the release stop 5114 as the firingassembly 5130 translates along the slot 5172 during the firing stroke.The firing assembly 5130 can push against the release stop 5114 at ornear the beginning of the firing stroke, for example. In certainembodiments, the release stop 5114 can be near the proximal end of theslot 5112, and an element of the firing assembly 5130, such as the nose5136, can abut the release stop 5114 upon the initiation of the firingstroke. When the nose 5136 is positioned against the release stop 5114,the nose 5136 can push against the actuator 5110 and move the actuator5110 distally. In certain embodiments, the actuator 5110 can movedistally until it reaches a hard stop 5160, for example. The hard stop5160 can be at the distal portion 5106 of the first jaw 5102 and/or theanvil frame 5170, and can prevent further distal movement of theactuator 5110, for example.

Referring primarily to FIG. 86, when the actuator 5110 is pusheddistally by the firing assembly 5130, the actuator 5110 can cut orotherwise overcome the distal connector 5180 to release the layer ofmaterial from the anvil frame 5172 at the distal portion 5106 of thefirst jaw 5102. In certain embodiments, the actuator 5110 can include anotch 5124 for receiving and holding the distal connector 5180. Thenotch 5124 can hold the distal connector 5180 as the actuator 5110shifts distally toward the hard stop 5160. Further, the actuator 5110can include a cutting edge 5120, for example, along the notch 5124. Incertain embodiments, when the actuator 5110 moves toward the hard stop5160, the distal connector 5180 can be pushed between the hard stop 5160and the cutting edge 5120 of the actuator 5110. In various embodiments,the cutting edge 5120 can cut the distal connector 5180 when the cuttingedge 5120 is pushed into the hard stop 5160. In such embodiments, thedistal connector 5080 can be cut by the cutting edge 5120 of theactuator 5110 at or near the beginning of the firing stroke. In variousembodiments, the actuator 5110 can overcome the distal connector 5180without cutting it. For example, the actuator 5110 can dislodge orstretch the distal connector 5180 out of position such that the distalconnector 5180 no longer holds the layer of material relative to theanvil frame 5170.

In various embodiments, additional connectors along the length of theanvil frame 5170 can be cut or otherwise overcome by the actuator 5110at or near the beginning of the firing stroke. For example, a proximalcutting edge on the actuator 5110 can cut an additional proximalconnector and/or an intermediate cutting edge on the actuator 5110 cancut an additional intermediate connector. The various cutting edgesand/or portions of the actuator 5110 can cut or otherwise overcome eachof the connectors at and/or near the beginning of the firing stroke.Additionally or alternatively, a cutting edge of the firing assembly5130 can cut or otherwise overcome the additional connectors. Forexample, the firing assembly cutting edge can cut a connector at theproximal portion 5104 of the first jaw 5102 and the cutting edge 5120 ofthe actuator 5110 can cut the distal connector 5180 before the fastenersare ejected from the cartridge body of the second jaw. In certainembodiments, the actuator 5110 can overcome the distal connector 5180 asat least one fastener is ejected from a fastener cavity and/or after atleast one fastener has been ejected from a fastener cavity. When theactuator 5110 is blocked from further distal movement by the hard stop5160, the firing assembly 5130 can push through the release stop 5114 inthe slot 5112 of the actuator 5110. When the firing assembly 5130 pushesthrough the release stop 5114, the firing assembly 5130 can widen thewidth of the slot 5112 to permit passage of the firing assembly 5130therethrough. For example, the nose 5136 of the firing assembly 5130 canwiden the release stop 5114 such that the firing bar 5132 can extendthrough the release stop 5114 and translate along the slot 5112. Invarious embodiments, the release stop 5114 can be sufficiently rigid towithstand the force of the firing assembly 5130 as the actuator 5110shifts distally toward the hard stop 5160, and can be sufficientlyflexible to widen when the actuator 5110 reaches the hard stop 5160without requiring excessive force by a motor and/or an operator. Theactuator 5110 and/or the release stop 5114 thereof can comprisestainless steel, titanium, aluminum, liquid crystal polymer (LCP), nylonand/or ultem, for example. In various embodiments, the actuator 5110 canovercome the distal connector 5180 before a fastener is fired from thefastener cartridge of the second jaw. In certain embodiments, the distalconnector 5180 can be overcome after and/or while at least one fasteneris ejected from a fastener cavity. Upon extending through the releasestop 5114, the firing assembly 5130 can continue to move distally alongthe slot 5172 in the anvil frame 5172 and along the slot 5112 in theactuator 5110.

In various embodiments, an actuator can shift proximally when actuatedby the firing assembly. The proximally-shifting actuator can overcome aproximal connector, for example. In certain embodiments, a first pieceof an actuator can shift distally when actuated and a second piece ofthe actuator can shift proximally when actuated. The first and secondpieces of the actuator can simultaneously overcome the connectors. Forexample, the first piece of the actuator can overcome a proximalconnector as the second piece of the actuator overcomes the distalconnector.

In various embodiments, an end effector assembly can include a first jawand a second jaw. In certain embodiments, a layer of material can bereleasably secured to the first jaw and another layer of material can bereleasably secured to the second jaw. For example, a first layer ofmaterial can be releasably secured to a first jaw and/or an anvil frame,and a second layer of material can be releasably secured to a second jawand/or a fastener cartridge assembly. In certain embodiments, anactuator, such as actuator 5010, for example, can release the firstlayer of material from the first jaw, and a second actuator, such asactuator 5110, for example, can release the second layer of materialfrom the second jaw. The release of the first layer of material by thefirst actuator and the second layer of material by the second actuatorcan be timed. For example, the actuators can be arranged and/orconfigured such that the first and second layers of material can bereleased from the end effector assembly simultaneously and/orconsecutively.

Referring generally to FIGS. 87-90, an end effector of a surgicalstapling instrument can comprise a first jaw and a second jaw, whereinat least one of the first jaw and the second jaw can be configured to bemoved relative to the other. The end effector can comprise a first jawincluding a staple cartridge channel and a second jaw including an anvilsuch as, for example, anvil 2030 (FIG. 88A) which may include aplurality of forming pockets 2032 (FIG. 88A), wherein the anvil 2030 canbe pivoted toward and/or away from the staple cartridge channel. Thestaple cartridge channel can be configured to receive a staple cartridge2010 (FIG. 87) which can be removably retained within the staplecartridge channel. Tissue T can be captured between anvil 2030 andstaple cartridge 2010, for example, when anvil 2030 is pivoted towardthe staple cartridge channel.

Referring primarily to FIG. 87, a staple cartridge assembly such as, forexample, staple cartridge assembly 2000 can comprise a tissue thicknesscompensator, such as tissue thickness compensator 2020 and a staplecartridge, such as staple cartridge 2010, for example, which maycomprise a cartridge body 2012 and a multistep cartridge deck 2014. Asillustrated in FIG. 87, cartridge deck 2014 may comprise a slot 2016extending longitudinally therethrough, wherein the slot 2016 can beconfigured to receive a cutting member which can be slidably movedthrough slot 2016.

Further to the above, as illustrated in FIG. 87, cartridge deck 2014 maycomprise a plurality of surfaces 2018 a-c extending longitudinally alongslot 2016, wherein surface 2018 a may lie closer to slot 2016 thansurface 2018 b which may lie closer to slot 2016 than surface 2018 c.For example, surface 2018 b may be laterally offset from surface 2018 ain a direction away from slot 2016 and surface 2018 c may be laterallyoffset from surface 2018 b also in a direction away from slot 2016. Inaddition, surfaces 2018 a-c can be vertically offset from each other.For example, surfaces 2018 a-c may each lie, or at least substantiallylie, in a separate plane wherein the planes of surfaces 2018 a-c can bevertically offset from each other.

Further to the above, referring again to FIGS. 87-88B, the cartridge2010 can comprise a plurality of staple cavities 2022 within cartridgebody 2012, wherein cavities 2022 may comprise openings in surfaces 2018a-c of cartridge deck 2014. A staple can be positioned within eachstaple cavity 2022. For example, staples 2024 a-c can be positionedwithin cavities 2022 and can be supported by staple drivers 2026 a-cwithin cartridge body 2012. A sled and/or firing member, for example,can be advanced through the staple cartridge 2010 to lift the stapledrivers 2026 a-c upwardly within the staple cavities 2022 and eject thestaples 2024 a-c from cavities 2022 through the openings in the surfaces2018 a-c, respectively. The staples 2024 a-c may be formed by advancingthe staples 2024 a-c against corresponding forming pockets 2032 definedin the anvil 2030 while the anvil 2030 is in the closed position.

As illustrated in FIG. 88A, drivers 2026 a-c can be positioned atdifferent unfired distances from corresponding forming pockets 2032defined in the anvil 2030 when anvil 2030 is in a closed position. Forexample, as illustrated in FIG. 88A, drivers 2026 a can be positioned afirst unfired distance from their corresponding forming pockets 2032,drivers 2026 b can be positioned a second unfired distance from theircorresponding forming pockets 2032, and drivers 2026 c can be positioneda third unfired distance from their corresponding forming pockets 2032,wherein the first distance may be shorter than the second distance, andwherein the second distance may be shorter than the third distance, forexample. Referring now to FIG. 88B, the staple drivers 2026 a can drivethe staples 2024 a supported thereon to a first formed height 2021 a,staple drivers 2026 b can drive the staples 2024 b supported thereon toa second formed height 2021 b, and staple drivers 2026 c can drive thestaples 2024 c supported thereon to a third formed height 2021 c,wherein the first formed height 2021 a may be shorter than the secondformed height 2021 b and the second formed height 2021 b may be shorterthan the third formed height 2021 c, for example. Staples 2024 a-c cancomprise the same, or substantially the same, unformed or unfiredheight. Alternatively, the drivers 2026 a-c can support staples havingdifferent unformed heights. In addition, as illustrated in FIG. 88A, thetips of the unformed staples 2024 a-c can lie, or at least substantiallylie, in different planes in their unfired positions. Alternatively,staple cartridge 2010 may include unformed staples comprising stapletips that may lie, or at least substantially lie, in a single plane.Other embodiments are envisioned in which the staples 2024 a-c can beformed to any suitable formed heights and/or any relative formedheights.

Referring again to FIGS. 87-88B, the tissue thickness compensator 2020may include a plurality of portions, such as portions 2020 a-c (See FIG.87) which can be captured by staples 2024 a-c, respectively. Portions2020 a-c, as illustrated in FIG. 88A, can be laterally offset from eachother. For example, portions 2020 b can be laterally offset fromportions 2020 a in a direction away from slot 2016 and portions 2020 ccan be laterally offset from portions 2020 b also in a direction awayfrom slot 2016. Furthermore, Portions 2020 a-c, as illustrated in FIG.88A, may include deck contacting surfaces 2036 a-c, wherein compensator2020 can be positioned against cartridge deck 2014 such that deckcontacting surfaces 2036 a-c may be removably positioned against oradjacent surfaces 2018 a-c of deck 2014, respectively. Similar tosurfaces 2018 a-c, the deck contacting surfaces 2036 a-c can bevertically offset from each other. For example, as illustrated in FIG.88A, surfaces 2036 a-c may each lie, or at least substantially lie, in aseparate plane, wherein the planes of surfaces 2036 a-c can bevertically offset from each other. In other words, surface 2036 a maylie in a first plane, surface 2036 b may lie in a second plane, andsurface 2036 c may lie in a third plane, wherein the first plane iscloser than the second plane to a datum and the second plane is closerthan the third plane to a datum such as, for example, datum 2031 atanvil 2030. As illustrated in FIG. 88A, datum 2031 may comprise a planethat passes through anvil 2030 when anvil 2030 is in the closedposition, wherein datum 2031 may be parallel, or substantially parallel,to surfaces 2036 a-c.

Further to the above, as illustrated in FIG. 88A, the distance betweenthe planes of surfaces 2036 a and 2036 b can be the same, or at leastsubstantially the same as the distance between the planes of surfaces2036 b and 2036 c. Alternatively, the distance between the planes ofsurfaces 2036 a and 2036 b can be different from the distance betweenthe planes of surfaces 2036 b and 2036 c. For example, the distancebetween the planes of surfaces 2036 a and 2036 b can be smaller than thedistance between the planes of surfaces 2036 b and 2036 c.

Referring again to FIGS. 87-88B, portions 2020 a-c may comprise tissuecontacting surfaces 2034 a-c which can be positioned against or adjacenttissue T. Similar to surfaces 2018 a-c, as illustrated in FIG. 88A, thetissue contacting surfaces 2034 a-c may be vertically offset from eachother. For example, as illustrated in FIG. 88A, surfaces 2034 a-c mayeach lie, or at least substantially lie, in a separate plane, whereinthe planes of surfaces 2034 a-c can be vertically offset from eachother. In other words, surface 2034 a may lie in a first plane, surface2034 b may lie in a second plane, and surface 2034 c may lie in a thirdplane, wherein the first plane is closer than the second plane to adatum and the second plane is closer than the third plane to datum 2031,wherein datum 2031 may be parallel, or substantially parallel, tosurfaces 2036 a-c.

Further to the above, the distance between the planes of surfaces 2034 aand 2034 b can be the same, or at least substantially the same as thedistance between the planes of surfaces 2034 b and 2034 c.Alternatively, the distance between the planes of surfaces 2034 a and2034 b can be different from the distance between the planes of surfaces2034 b and 2034 c. For example, the distance between the planes ofsurfaces 2034 a and 2034 b can be smaller than the distance between theplanes of surfaces 2034 b and 2034 c.

Referring to FIGS. 88-90, portions 2020 a-c of compensator 2020 maycomprise a uniform, or substantially uniform uncompressed thickness. Forexample, as illustrated in the cross-sectional view in FIG. 88, portions2020 a may comprise a first uncompressed thickness between surfaces 2034a and surfaces 2036 a and portions 2020 b may comprise a seconduncompressed thickness between surfaces 2034 b and surfaces 2036 b,wherein the first uncompressed thickness can be the same orsubstantially the same as the second uncompressed thickness. Inaddition, portions 2020 c can comprise a third uncompressed thicknessbetween surfaces 2034 c and 2036 c, wherein the third uncompressedthickness can be the same, or substantially the same as the firstuncompressed thickness and/or the second uncompressed thickness.

Alternatively, compensator 2020 may comprise portions having differentuncompressed thicknesses, wherein all or some of portions 2020 a-c maycomprise different uncompressed thicknesses. For example, as illustratedin FIG. 89, the third uncompressed thickness of portions 2020 c may begreater than the second uncompressed thickness of portions 2020 a whilethe first uncompressed thickness of portions 2020 a may comprise thesame, or substantially the same, uncompressed thickness as the seconduncompressed thickness of portions 2020 b. Under certain circumstances,the second uncompressed thickness can be greater than the firstuncompressed thickness and the third uncompressed thickness can begreater than the second uncompressed thickness thereby forming athickness gradient. Accordingly, compensator 2020 may comprise athickness gradient, wherein the uncompressed thickness of certainportions of compensator 2020 may depend on the relative position ofthese portions. For example, compensator 2020 may comprise centralportions having a minimum uncompressed thickness, peripheral portionshaving a maximum uncompressed thickness, and intermediate portionshaving a medium uncompressed thickness. Alternatively, the centralportions may comprise a maximum uncompressed thickness and theperipheral portions may comprise a minimum uncompressed thickness. Thereader will appreciate that the thickness of portions 2020 a-c and theirrelative positions within the compensator 2020 can be configured toprovide a desired thickness compensation for the tissue T within theformed staples 2024 a-c.

Further to the above, as illustrated in FIG. 88B, formed staples 2024a-c may capture tissue T and/or compensator 2020, wherein capturedtissue T and captured compensator 2020 may compete for space withinformed staples 2024 a-c. Accordingly, tissue T and/or compensator 2020can be compressed under compression forces applied thereto by formedstaples 2024 a-c which may depend, at least in part, on the formedheights of the staples 2024 a-c, compressibility of tissue T,compressibility of compensator 2020, tissue T thickness, and/orcompensator 2020 thickness. Accordingly, some or all of these parameterscan be manipulated to yield a desired compression in the tissue T withinthe formed staples 2024 a-c.

Further to the above, the compressibility of the tissue T may depend, atleast in part, on the modulus of elasticity of the tissue T and thecompressibility of compensator 2020 may depend, at least in part, on themodulus of elasticity of compensator 2020, wherein a greater modulus ofelasticity may result in greater compressibility. For example, asillustrated in FIG. 88B, staples 2024 a may capture correspondingportions 2020 a of compensator 2020 and corresponding tissue T which mayresult in a competition for space between the portions 2020 a andcorresponding tissue T within the formed staples 2024 a. In the exampleillustrated in FIG. 88B, the tissue T may comprise a greater modulus ofelasticity than the corresponding portions 2020 a. Accordingly, formedstaples 2024 a may compress tissue T to a greater degree thancorresponding portions 2020 a. Furthermore, as described above and asillustrated in FIG. 88B, the formed height 2021 a of staples 2024 a maybe shorter than the formed height 2021 b of staples 2024 b and theformed height 2021 b may be shorter than the formed height 2021 c ofstaples 2024 c. Accordingly, the space available within formed staples2024 a may be less than the space available within formed staples 2024 bwhich may be less than the space available within formed staples 2024 c.In result, the tissue T within formed staples 2024 a may be compressedto a greater degree than the tissue T within formed staples 2024 b whichmay be compressed to a greater degree than the tissue T within formedstaples 2024 c.

Further to the above, portions 2020 a-c of compensator 2020 may comprisedifferent moduli of elasticity which may result in different degrees ofcompressibility across compensator 2020. For example, portions 2020 amay comprise a greater modulus of elasticity than the portions 2020 band the portions 2020 b may comprise a greater modulus of elasticitythan the portions 2020 c. In result, a modulus of elasticity gradientmay exist across the compensator 2020 wherein a central portion, forexample one of the portions 2020 a, may comprise a greater modulus ofelasticity than a peripheral portion, for example one of the portions2020 c. In addition, an intermediate portion, for example one of theportions 2020 b, may comprise a greater modulus of elasticity than theperipheral portion and a lesser modulus of elasticity than the centralportion. Accordingly, tissue T within the formed staples 2024 a-c may beconfigured to experience a desirable compression force by manipulatingthe modulus of elasticity of the corresponding portions 2020 a-c.

Referring again to FIG. 88B, as described above, the compression forcesexperienced by the tissue T and the compensator 2020 may depend, atleast in part, on the heights 2021 a-c of the formed staples 2024 a-cwhich may determine the total space available within formed staples 2024a-c for the tissue T and the corresponding portions 2020 a-c ofcompensator 2020 to compete therein. For example, as illustrated in FIG.88B, the space available within formed staples 2024 c may be greaterthan the space available within formed staples 2024 b and the spaceavailable within formed staples 2024 b may be greater than the spaceavailable within formed staples 2024 a. In result, tissue T andcorresponding portions 2020 a may experience greater compression forceswithin staples 2024 a than that experienced by tissue T andcorresponding portions 2020 b within formed staples 2024 b. In addition,tissue T and corresponding portions 2020 b may experience greatercompression forces within formed staples 2024 b than that experienced bytissue T and corresponding portions 2020 c within formed staples 2024 c.Accordingly, a tissue compression gradient can be established, whereintissue T within formed staples 2024 a may experience a greatercompression than tissue T within formed staples 2024 b and tissue Twithin staples 2024 b may experience a greater compression than tissue Twithin staples 2024 c. Other embodiments are envisioned in which atissue thickness compensator and formed staples can be made to induce asuitable compression through the tissue T within the formed staples.

Further to the above, referring to FIG. 89, a tissue thicknesscompensator 2020′ may comprise a plurality of portions 2020′a-c. Thecompression forces experienced by tissue T and the compensator 2020′upon being captured by staples 2024 a-c can depend, at least in part,upon the thickness of portions 2020′a-c of compensator 2020′. Theportions 2020′a-c may comprise different uncompressed thicknesses. Forexample, as illustrated in FIG. 89, the portions 2020′c may comprise agreater uncompressed thickness than the portions 2020′a and 2020′b whichmay result in a greater compression in the tissue T captured by staples2024 c than the tissue T captured by staples 2024 a and 2024 b. Undercertain circumstances, the compression forces experienced by capturedtissue T and captured compensator 2020′ may be directly proportional tothe thickness of compensator 2020′.

Referring now to FIG. 90, a tissue thickness compensator composite suchas, for example, composite 2060 can comprise multiple tissue thicknesscompensators. For example, composite 2060 may comprise tissue thicknesscompensator 2020 and tissue thickness compensator 2080, whereincompensator 2080 can be positioned, at least in part, adjacent oragainst compensator 2020. For example, compensator 2080 can beselectively positioned over certain portions of compensator 2020 toprovide, for example, a desirable thickness and/or compliance. Asillustrated in FIG. 90, compensator 2080 may comprise portions 2080 cwhich can be positioned over, for example, portions 2020 c ofcompensator 2020.

Further to the above, compensator 2080 and compensator 2020 can bejoined together, for example, by an adhesive. Other attachment means forattaching compensator 2020 to compensator 2080 are contemplated withinthe scope of this disclosure. Similar to compensator 2020, the portionsof compensator 2080 may comprise various thicknesses, moduli ofelasticity, and/or relative spatial arrangements. Furthermore, theportions of compensator 2080 and the corresponding portions ofcompensator 2020 may comprise the same or different uncompressedthickness and/or moduli of elasticity. For example, portions 2080 c maycomprise a higher modulus of elasticity than portions 2020 c to provideand may provide a compliant tissue contacting surface on a peripheralregion of composite 2080.

Further to the above, compensator 2020 and/or compensator 2080 may becomprised of biocompatible materials. In addition, compensator 2020and/or compensator 2080 may be comprised of biodegradable materials suchas, for example, PGA, PCL, PLLA, and/or combinations thereof, forexample. Compensator 2020 and compensator 2080 may be comprised of thesame material or different materials to yield a desired localizedcompressibility across composite 2080.

As described herein, a tissue thickness compensator can compensate forvariations in the thickness of tissue that is captured within thestaples ejected from a staple cartridge and/or contained within a stapleline, for example. Stated another way, certain staples within a stapleline can capture thick portions of the tissue while other staples withinthe staple line can capture thin portions of the tissue. In suchcircumstances, the tissue thickness compensator can assume differentheights or thicknesses within the staples and apply a compressive forceto the tissue captured within the staples regardless of whether thecaptured tissue is thick or thin. In various embodiments, a tissuethickness compensator can compensate for variations in the hardness ofthe tissue. For instance, certain staples within a staple line cancapture highly compressible portions of the tissue while other stapleswithin the staple line can capture portions of the tissue which are lesscompressible. In such circumstances, the tissue thickness compensatorcan be configured to assume a smaller height within the staples thathave captured tissue having a lower compressibility, or higher hardness,and, correspondingly, a larger height within the staples that havecaptured tissue having a higher compressibility, or lower hardness, forexample. In any event, a tissue thickness compensator, regardless ofwhether it compensates for variations in tissue thickness and/orvariations in tissue hardness, for example, can be referred to as a‘tissue compensator’ and/or as a ‘compensator’, for example.

The devices disclosed herein can be designed to be disposed of after asingle use, or they can be designed to be used multiple times. In eithercase, however, the device can be reconditioned for reuse after at leastone use. Reconditioning can include any combination of the steps ofdisassembly of the device, followed by cleaning or replacement ofparticular pieces, and subsequent reassembly. In particular, the devicecan be disassembled, and any number of the particular pieces or parts ofthe device can be selectively replaced or removed in any combination.Upon cleaning and/or replacement of particular parts, the device can bereassembled for subsequent use either at a reconditioning facility, orby a surgical team immediately prior to a surgical procedure. Thoseskilled in the art will appreciate that reconditioning of a device canutilize a variety of techniques for disassembly, cleaning/replacement,and reassembly. Use of such techniques, and the resulting reconditioneddevice, are all within the scope of the present application.

Preferably, the invention described herein will be processed beforesurgery. First, a new or used instrument is obtained and if necessarycleaned. The instrument can then be sterilized. In one sterilizationtechnique, the instrument is placed in a closed and sealed container,such as a plastic or TYVEK bag. The container and instrument are thenplaced in a field of radiation that can penetrate the container, such asgamma radiation, x-rays, or high-energy electrons. The radiation killsbacteria on the instrument and in the container. The sterilizedinstrument can then be stored in the sterile container. The sealedcontainer keeps the instrument sterile until it is opened in the medicalfacility.

Various embodiments described herein are described in the context ofstaples removably stored within staple cartridges for use with surgicalstapling instruments. In some circumstances, staples can include wireswhich are deformed when they contact an anvil of the surgical stapler.Such wires can be comprised of metal, such as stainless steel, forexample, and/or any other suitable material. Such embodiments, and theteachings thereof, can be applied to embodiments which include fastenersremovably stored with fastener cartridges for use with any suitablefastening instrument.

Various embodiments described herein are described in the context oftissue thickness compensators attached to, and/or for use with, staplecartridges and/or fastener cartridges. Such tissue thicknesscompensators can be utilized to compensate for variations in tissuethickness from one end of a staple cartridge to another, or forvariations in tissue thickness captured within one staple, or fastener,as compared to another. Such tissue thickness compensators can also beutilized to compensate for variations in tissue thickness from one sideof a staple cartridge to another. Such embodiments, and the teachingsthereof, can be applied to embodiments which include a layer, or layers,of material attached to, and/or for use with, staple cartridges and/orfastener cartridges. A layer can include buttress material.

Various embodiments described herein are described in the context oflinear end effectors and/or linear fastener cartridges. Suchembodiments, and the teachings thereof, can be applied to non-linear endeffectors and/or non-linear fastener cartridges, such as, for example,circular and/or contoured end effectors. For example, various endeffectors, including non-linear end effectors, are disclosed in U.S.patent application Ser. No. 13/036,647, filed Feb. 28, 2011, entitledSURGICAL STAPLING INSTRUMENT, now U.S. Patent Application PublicationNo. 2011/0226837, which is hereby incorporated by reference in itsentirety. Additionally, U.S. patent application Ser. No. 12/893,461,filed Sep. 29, 2012, entitled STAPLE CARTRIDGE, now U.S. PatentApplication Publication No. 2012/0074198, is hereby incorporated byreference in its entirety. U.S. patent application Ser. No. 12/031,873,filed Feb. 15, 2008, entitled END EFFECTORS FOR A SURGICAL CUTTING ANDSTAPLING INSTRUMENT, now U.S. Pat. No. 7,980,443, is also herebyincorporated by reference in its entirety.

Any patent, publication, or other disclosure material, in whole or inpart, that is said to be incorporated by reference herein isincorporated herein only to the extent that the incorporated materialsdoes not conflict with existing definitions, statements, or otherdisclosure material set forth in this disclosure. As such, and to theextent necessary, the disclosure as explicitly set forth hereinsupersedes any conflicting material incorporated herein by reference.Any material, or portion thereof, that is said to be incorporated byreference herein, but which conflicts with existing definitions,statements, or other disclosure material set forth herein will only beincorporated to the extent that no conflict arises between thatincorporated material and the existing disclosure material.

While this invention has been described as having exemplary designs, thepresent invention may be further modified within the spirit and scope ofthe disclosure. This application is therefore intended to cover anyvariations, uses, or adaptations of the invention using its generalprinciples. Further, this application is intended to cover suchdepartures from the present disclosure as come within known or customarypractice in the art to which this invention pertains.

1-25. (canceled)
 26. A staple cartridge assembly for use with a surgicalinstrument, wherein said staple cartridge assembly comprises: acartridge body, comprising: a longitudinal slot configured to receive acutting member of the surgical instrument; a deck; a plurality of staplecavities; and a plurality of staples removably stored in said staplecavities; an implantable layer on said deck, wherein said staples areconfigured to at least partially capture said implantable layer whensaid staples are moved between an unfired position and a fired positionduring a tissue cutting stroke of the cutting member, and wherein saidimplantable layer comprises: a first portion configured to be completelysevered by the cutting member during the tissue cutting stroke, whereinsaid first portion comprises a first plurality of perforations definedon an edge thereof; a second portion configured to be partially severedby the cutting member during the tissue cutting stroke, wherein saidsecond portion comprises a second plurality of perforations on an edgethereof, and wherein said first plurality of perforations have adifferent frequency for a given edge length than said second pluralityof perforations; a first cutout located proximal to said staplecavities; and a second cutout located distal to said staple cavities; afirst attachment member positioned in said first cutout, wherein saidfirst attachment member is configured to hold said implantable layer tosaid cartridge body, and wherein said first attachment member is severedby the cutting member during the tissue cutting stroke; and a secondattachment member positioned in said second cutout, wherein said secondattachment member releasably holds said implantable layer to saidcartridge body.
 27. A staple cartridge assembly for use with a surgicalinstrument, wherein said staple cartridge assembly comprises: acartridge body, comprising: a longitudinal slot configured to receive acutting member of the surgical instrument; a deck; a plurality of staplecavities; and a plurality of staples removably stored in said staplecavities; an implantable layer positioned over said deck, wherein saidstaples are configured to at least partially capture said implantablelayer when said staples are moved between an unfired position and afired position during a tissue cutting stroke of the cutting member, andwherein said implantable layer comprises: a distal portion configured tobe partially severed by the cutting member during the tissue cuttingstroke, wherein said distal portion comprises a first plurality ofperforations; and a proximal portion configured to be completely severedby the cutting member during the tissue cutting stroke, wherein saidproximal portion comprises a second plurality of perforations, andwherein said first plurality of perforations are more frequent than saidsecond plurality of perforations; a first attachment member positionedproximal to said staple cavities; and a second attachment memberpositioned distal to said staple cavities, wherein said first and secondattachment members are configured to releasably hold said implantablelayer to said cartridge body, and wherein said first attachment memberis severed by the cutting member during the tissue cutting stroke.